Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention, delivers remarks at a press conference September 29, 2016 in Washington, DC.
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When the United States experiences sudden outbreaks of illness, the federal government usually appoints a spokesperson. This person communicates the latest data, makes recommendations to ensure the safety of people and provides a calm and reassuring voice until the storm passes.
Most experts in health communication agree that the person must be a scientist – not a politician. This is particularly the case for a politically polarized country like the United States.
“It is essential that the public face of health information about the coronavirus is a highly respected public health figure,” said Lawrence Gostin, professor of global health law and director of the O’Neill Institute for National and Global Health Law in Georgetown. University. “The public must trust this person to provide unbiased, science-based information.”
When politicians override, he explained, it can add a layer of policy to a science-based recommendation. Already, this seems to be happening during the Covid-19 crisis. The population is deeply divided on issues ranging from vaccines to wearing masks in public. Wearing a mask – which is now the CDC’s recommendation, particularly in areas where it is difficult to meet social distancing guidelines – has increasingly become a political statement.
Where’s the CDC?
Communication with the public is so important that the CDC Field Epidemiology Manual devotes an entire chapter to the subject.
The recommendations indicate that the spokesperson should have a consistent message (a “SOCO” or “primary overarching communication goal”), which could be a specific health recommendation, such as “wear a mask” or “stay six feet strangers”. Their tone is vitally important, says the manual, and they should be empathetic but clear about the challenges we face, whether it be a shortage of tests or delays in producing a vaccine. .
As director of the Centers for Disease Control in the United States from 2009 to 2017, Dr. Tom Frieden assumed this role of spokesperson.
“During Zika, H1N1, Ebola, we usually had daily briefings with all the major media outlets covering them,” said Frieden, who is now the president and CEO of Resolve to Save Lives, an advocacy group.
“I would feel safer and we would all be safer if we heard the CDC regularly,” he said.
In the United States, President Trump has asked the public to regularly attend White House briefings for updates on the coronavirus. Local officials like New York Governor Andrew Cuomo and California governor Gavin Newsom followed suit, leaving doctors and scientists mostly on the sidelines.
Dr. Anthony Fauci has emerged as the most prominent coronavirus scientist, but his appearances alongside the President have been inconsistent, often leading to speculation about the reasons for his disappearance.
President Donald Trump is accompanied by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, while speaking about the development of the coronavirus vaccine in the White House rose garden May 15, 2020 in Washington, DC .
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Frieden has known Fauci for years and calls himself “a brilliant scientific communicator and researcher”. But, says Frieden, he is not a leading specialist in respiratory disease control. These experts at the CDC include Dr. Nancy Messonnier, who anger in the early months of the pandemic for issuing urgent warnings to the public, and Dr. Anne Schuchat, the agency’s number two. The two made a few comments to the press, but neither appeared to be a public face for the response to the pandemic.
Meanwhile, Fauci, who advised six presidents and plays a central role in the White House coronavirus task force, admitted that he was not always able to correct the lies he hears President Trump at press conferences, including exaggerations on the number of tests available. “I can’t jump in front of the microphone and push it down,” he told CNN.
At this point, it would be difficult for any public health official to reach consensus. Some are successful locally, such as in states like California and Washington, but there is a lack of consistent understanding across the country.
“Dr. Fauci is among the best health communicators in America. His authoritarian and reassuring voice is highly respected by the public. Yet he operates during a period of politicization of science in a way never seen before in modern America” said Gostin. “Health information should not be seen through a political lens but through the lens of science”
Fill the gap
Experts outside the federal government are doing their best to fill the void, answering questions about safe travel, trips to the park or getting kids back to school.
Medically, providers caring for Covid-19 patients like Brigham and Women’s Hospital Dr. Jeremy Faust, Rhode Island Hospital Dr. Megan Ranney and Oregon Health & Science University Dr. Esther Choo are frequent voices in the air talking about life inside the hospital during a pandemic.
Dr. Ashish Jha, director of the Harvard Global Health Institute, has also become a leading voice in public health.
Jha, who urged the CDC to talk outside at a time when its experts are most needed, says it is ready to continue to communicate with the public – but it recognizes that it is not the national spokesperson that the Americans need.
“I don’t have the data [CDC director] Robert Redfield has, “he said over the phone.” We all use publicly available data and do our best with what we have. “
Jha said it is unfortunate that Fauci does not seem to have the freedom to take the helm during this crisis. He describes the role of Fauci as “not a complete Fauci but a half-Fauci”, because he seems “constrained and he cannot contradict the president”.
Jha said he now makes four to six television appearances a day, in addition to his day job, to provide advice on how to reopen the economy safely. He would be willing to step back if and when a real spokesperson emerges. “I hear people all the time saying that they don’t know who to turn to or who to trust,” he said. “There is no glory in it … we are making up for the federal government’s lack of communication.”
Dr. Ranney, emergency physician and public health expert, agrees.
“I will do my best to continue to spread the science and raise the profile of public health,” she said. “But a good public health message requires trust and consistency (and ideally, it comes from our government leaders.”