Coronavirus Crisis Highlights Importance of Effective Public Health Communication

It was 6:28pm on the day Santa Clara County announced its first COVID-19 case of unknown origin when a friend texted Public Health Department spokesman Maury Kendall about the MSNBC shout-out.

Primetime host Rachel Maddow had just read the county’s public health advisory on air, the text read, and “said it should be a template for the country.”

Kendall relayed as much to his colleagues “and everyone woohooed,” he says. Minutes later, he got another, more detailed text, which elicited “more happy, tired smiles.”

By the time that Maddow clip aired on the second-to-last day of last month, President Donald Trump had the country’s head spinning with mixed messages about the novel coronavirus outbreak. The commander-in-chief lied about the pace of vaccine development, the spread of the respiratory disease, downplayed it as just another flu strain, told the Centers for Disease Control to keep certain information under wraps and promised the number of cases would soon fall to zero.

“I mean, I don’t have too much sympathy for Vice President Mike Pence being in charge of this, but If I were him, I would have no idea how to coordinate government communications about this with the guy at the top saying what he’s saying,” Maddow told a guest the night before.

On Feb. 28, Maddow held up the press release in which Santa Clara County Public Health Officer Dr. Sara Cody talks about the community transmission case as a signal that “now is the time to change course” and that the community should prepare for “widespread transmission.” The MSNBC host presented the advisory as an antidote to that kind of confusion and disinformation, describing it as “an admirably direct, straightforward announcement and alert about this case and what it means.”

“I’m no expert,” Maddow told viewers, “but this looks like the sort of thing that we might reasonably use as a model for frank communication about these kinds of things.”

Joy Alexiou, who leads the county’s public health communications team, says the high-profile affirmation came at the end of “a particularly long and hard” day.

“It felt really good to get commended on that,” she says. “It was definitely a team effort that went into crafting that press release. And you know, as a writer, it really helps when the expert, Dr. Cody, really knows what she’s talking about.”

During an ongoing crisis, the way experts and leaders talk to the public carries profound weight. People rely on information from authorities to make sense of an unfolding event and figure out how to respond. Done well, crisis communications manage fears and expectations and makes it more likely that people will take heed to guidance.

If botched or politicized, risk communications stoke distrust in institutions and expertise.

Alexiou’s team has to balance transparency and assurance. Too much of the former may freak people out and too much of the latter may give them a false sense of security.

In recent weeks, the advisories have come from all angles.

The Children’s Discovery Museum in downtown San Jose announced its temporary closure shut down because of suspected exposure to the virus. As did a local preschool and the city’s senior meals program.

San Jose Mayor Sam Liccardo proposed banning evictions to protect tenants impacted by layoffs and business closures caused by the outbreak. Gov. Gavin Newsom told insurance companies to waive out-of-pocket costs for COVID-19 testing. Sequoia Capital, one of the world’s leading VC firms, called the COVID-19 pandemic the “Black Swan of 2020.”

Just this week, Dr. Cody issued more frank announcements that heightened the sense of urgency about the new storied strain of coronavirus as the number of local cases reached 43 and the county saw its first COVID-19-related death.

On Monday—two days after the Cinequest film festival announced its postponement until later this year—the county became the first in the nation to impose a mandatory moratorium on “mass gatherings.” For the next month or so, assemblies of 1,000 or more people are strictly prohibited.

“This is a critical moment in the growing outbreak of COVID-19 in Santa Clara County,” Dr. Cody cautioned in the Monday morning press release. “The strong measures we are taking today are designed to slow the spread of disease.”

Motivational speaker Tony Robbins, who was scheduled for events over four days this week at the SAP Center, canceled his appearances. San Jose Sharks spokeswoman Joanna Schimmel said the SAP Center has no events scheduled until next week and that the venue will offer some updates for patrons after “reviewing each scheduled event due to take place for the rest of the month.” Other large-scale events made similar announcements about postponements or cancelations.

The scale and seriousness of the precautions have prompted some panic—especially for risk-prone populations such as the elderly, those with respiratory illness and chronic health conditions such as diabetes. At big-box stores throughout the Bay Area, shelves that normally carry hand sanitizer, soaps, toilet paper and face masks are depleted. Even on Amazon, the remaining Purell bottles are selling for $80 a pop.

Some of the fear owes more to uncertainty about how well-equipped the American healthcare system is to handle an influx of COVID-19 patients and how fatal the new coronavirus strain is compared to the common flu. According to what the World Health Organization has been able to determine so far, COVID-19’s mortality rate hovers somewhere between 3 and 4 percent—well over the 0.1 percent fatality rate of influenza.

With so many questions still unanswered, it’s better to over-prepare than minimize the threat, according to Ron Klain, who oversaw the Ebola response under President Barack Obama. While testifying before Congress last month, the attorney called the COVID-19 outbreak “a wake-up call” for the U.S. and advised that the best way to communicate that to the public is by being honest about the uncertainty.

In a March 6 piece for the New York Times, columnist and former Metro/San Jose Inside writer Michelle Goldberg echoed Klain’s point about candor, saying that people die at higher rates from disease outbreaks in authoritarian countries because those governments restrict the flow of information. That’s what happened in China, she argued in her commentary: as COVID-19 spread outward from Wuhan, President Xi Jinping played down the threat and retaliated against doctors who tried sounding the alarm.

Jinping’s counterpart here in the U.S. has taken a similar tack. “So far,” she wrote, “Donald Trump’s response to the coronavirus combines the worst features of autocracy and of democracy, mixing opacity and propaganda with leaderless inefficiency.”

The lack of clarity from on high puts greater pressure on local officials, including Santa Clara County’s Dr. Sara Cody and the 10-person cohort that handles her department’s communications. “Crisis comms success depends on a solid team working well together, and we have that,” Kendall says. “Having Rachel Maddow validate our core concepts of clear, open communication really kept the team motivated.”

Jennifer Wadsworth is the former news editor for San Jose Inside and Metro Silicon Valley. Follow her on Twitter at @jennwadsworth.


    • > Dr. Sara Cody and her team are SUPERB! They should really run the entire County.

      What does Dr. Sara Cody have to say about little old ladies with 125 cats and cat feces piles in the dining room taking their reusable shopping bags through the checkout lane at the Whole Foods market?

      Cats don’t get coronavirus, do they?

    • > If botched or politicized, risk communications stoke distrust in institutions and expertise.

      – – – –

      > Jinpng’s counterpart here in the U.S. has taken a similar tack. “So far,” she wrote, “Donald Trump’s response to the coronavirus combines the worst features of autocracy and of democracy, mixing opacity and propaganda with leaderless inefficiency.”

      My distrust in Jennifer and San Jose Inside has definitely been stoked.

  1. Remember, Dr. Sara Cody is also the official who said at a press conference not to touch your face, eyes, nose or mouth – then licked her fingers to turn a document page less than a minute later. False prophet!

  2. > Coronavirus Crisis Highlights Importance of Effective Public Health Communication

    Oh, for criminy sakes! STOP with the preposterous BS!

    COVID-19 is a contagious virus. Lots and lots of people are going to get it.

    I fully expect to get it. It’ll be like the flu. Maybe worse. Maybe not as bad.

    There’s NO POINT in keeping a scoreboard of how many “new cases” there are,

    Lots and lots of people will have miserable symptoms. And then lots of lots of people will recover and be immune.

    There’s probably not much the government can do about it. Trump can’t save us. Obama can’t save us. And for sure, a senile doofuss or a Trotskyite political apparatchik can’t save us.

    Quarantines probably don’t work:

    > Do quarantines work well anyway?

    > Maybe not. A quarantine after the 2003 outbreak of SARS in Toronto was deemed “both inefficient and ineffective,” according to an article published by The Canadian Journal of Infectious Diseases & Medical Microbiology.

    And fear and chaos just allows scammers to scam

    > How can taxpayers be protected from a money grab?

    > During health emergencies such as this one, enormous sums of taxpayer money exit the public coffers at the speed of light. Nobody wants to be blamed for appearing to hold back on money needed to save lives. Politicians in both parties risk getting blamed if they ask too many questions about exactly how all those emergency billions will be spent and how much is really needed. Sometimes, accountability goes out the window.

    Sometimes, people have to act like grown ups. Viruses aren’t fun, but they’re a part of human existence.

    Suck it up. Wash your hands. Take your medicine. Stop whining. And tough it out.

    And tell Rachel Maddow to stuff it and then turn off the TV.

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