COVID-19 Risk Communication Q&A

You were talking about this as early as the first week of February, if not before. What were you observing then about the way the government and the private sector were preparing for or communicating about the pandemic that concerned you?

Although it looked early on like the virus would spread globally, it wasn’t obvious at first how severe the COVID-19 pandemic would be. So the right message would have been about preparedness, logistical and emotional, for the hard time that might be coming.

But experts and officials – even those who knew a severe pandemic was a distinct possibility – chose instead to reassure the public. Alas, to everyone’s subsequent dismay, they succeeded. Many leaders, including WHO Director General Tedros Adhanom Ghebreyesus and New York Governor Andrew Cuomo, said that fear or hysteria was worse than the virus. They were worried about public panic. So they validated the public’s complacency, and left us incredibly unprepared.

The “us” they left unprepared includes most corporate leaders, who paid far too much attention to official claims that the risk was low – and far too little attention to their own risk matrices. Nearly every company of significant size has taken enterprise risk management onboard, and nearly every enterprise risk management effort incorporates a probability-by-magnitude matrix to help management identify risks worth mitigating. Those matrices teach that a risk whose magnitude is devastatingly high deserves increasing amounts of preparedness effort as its estimated short-term probability rises from very low to low toward moderate.

And to a large extent public health officials bought into their own over-reassurances. They, too, failed to prepare, and failed to convince their political bosses to prepare.

All this came about when public trust in institutions – business as well as government – is at a low point. To what extent has this made pre-crisis planning and crisis communications difficult?

It is possible that low trust would have prevented the public from heeding warnings about a possibly severe COVID-19 pandemic to come. It’s hard to know, since there were so few such warnings.

Certainly low trust didn’t keep the public from heeding all those over-reassurances. Wouldn’t it have been wonderful if more people had mistrusted all those officials who said “nothing for you to worry about” and prepared anyway!

I do think the public health establishment may have worried about a boy-who-cried-wolf mistrust problem. There have been a bunch of pandemic false alarms – most notably bird flu (the pandemic that didn’t happen) and swine flu (the pandemic that turned out milder than a typical flu season). It’s not so much that experts and officials were worried that their COVID-19 warnings might be mistrusted and therefore ignored. I suspect they were worried that COVID-19, too, might fizzle, and they’d be accused of alarmism yet again – and future warnings might be mistrusted. So they held their fire.

As for communications at the height of the pandemic crisis (so far), in mid-crisis the public tends to set aside any mistrust “for the duration” and follow instructions. So it’s not surprising that lockdown cooperation exceeded the expectations of the modelers. If anything, I think the majority of the public trusted the architects of lockdown too much.

Despite the survey evidence, I’m not convinced we’re in a period of low trust. I’d say it’s more polarized trust. Each side trusts its own leadership and its own media excessively, and misses or dismisses the other side’s share of the truth.

Did this take business by surprise?

Yes. But that’s not a fair question. A once-in-a-century black swan is supposed to take us by surprise. Of course a severe pandemic was on everybody’s list of low-probability high-magnitude risks that might eventually engulf us. But everybody also knew that the moment it did so would come as a surprise.

Maybe business should have done more long-term pandemic preparedness. But decades ago I was convinced by the late Aaron Wildavsky that preparing specifically for unlikely risks is a bad investment. There are too many unlikely risks; you usually find you wasted resources preparing for the wrong ones. Wildavsky understood that as an unlikely risk starts looking less unlikely, the case for just-in-time preparedness strengthens. Until then, he argued, both businesses and governments should build in more capacity for all-hazards resilience instead of trying to guess which unlikely disasters are going to materialize. Rather than asking how prepared companies were, maybe we should be asking how resilient they were.

But Wuhan in January was a real-world heads-up. A novel virus was already devastating a big city in a way the world hasn’t seen since the Spanish Flu, if then. Wuhan might have turned out to be a false alarm, of course, but it was certainly an alarm. It meant a severe pandemic was no longer a long-term low-probability risk, but now a short-term risk of middling probability. Wuhan should have been enough to get corporate risk managers and CEOs to dig out, update, and begin implementing their pandemic plans – in January or early February at the latest, not in March. In most cases that didn’t happen.

Who seems to be aware and has handled it well. Name names?

I don’t know enough to identify company officials who have done a good job of pandemic management or pandemic communication (or pre-pandemic planning and warning).

Corporate communications to the general public all seem pretty much the same: “We’re all in this together; we salute the heroes on the front line; here’s how our company is stepping up.” Behind the homogenous and somewhat treacly rhetoric, I assume some companies are doing a much better job than others of guiding and helping their stakeholders, especially their employees. I just don’t know which ones.

Looking at government pandemic communications, I started to make a list of standout performers. Then I realized that I had to cut some really good communicators from my list because I was aware of disqualifying moments. That left other really good communicators on my list who probably had disqualifying moments I didn’t know about. So I decided not to give you a list.

But that’s really too bad. My wife and colleague Jody Lanard and I keep talking about putting together a list of qualifying moments – spectacularly good fragments of pandemic communication worth emulating even if the very same communicators have sometimes been over-reassuring or overconfident or dishonest or unempathic. Maybe we’ll eventually get to it.

Jody says I should at least add a few names of leaders who have had excellent moments. So with the important qualifier that some (maybe all) have had awful moments too, here’s a short list:

• The CDC’s Dr. Nancy Messonnier
• New Zealand Prime Minister Jacinda Ardern
• British Columbia’s Dr. Bonnie Henry
• Santa Clara County’s Dr. Sarah Cody
• Singapore Prime Minister Lee Hsien Loong
• Ohio Health Department’s Dr. Amy Acton
• New York Governor Andrew Cuomo
• Seattle/King County’s Dr. Jeff Duchin.

Without naming names, what mistakes have you seen companies and nonprofits make?

In 2005–2007, fears of a horrific bird flu pandemic were widespread among experts, officials, and the general public. I worked on pandemic preparedness and pandemic planning with scores of companies and nonprofits (and governments too). Often jointly with my wife and colleague Jody Lanard, I wrote articles for my website on various aspects of pandemic communication, including a long four-part article on “What to Say When a Pandemic Looks Imminent.”

The bird flu pandemic never happened (so far, anyway), and the swine flu pandemic of 2009–2010 was mild – so 2020 was the first opportunity for companies and nonprofits to dust off and implement their bird flu pandemic plans.

To the best of my knowledge, they didn’t.

I’m not especially critical of how companies and nonprofits have weathered the pandemic crisis itself. We’re all muddling through as best we can. Most organizations are doing as well as could be expected. Some – many, even – are doing better than could be expected. An important exception: companies that have shown a callous disregard for their lowest-paid employees.

But virtually all companies and nonprofits missed the pre-crisis opportunity to prepare themselves, their employees, and their stakeholders. The World Health Organization declared COVID-19 to be a Public Health Emergency of International Concern on January 30. By then government officials in the U.S. and elsewhere were issuing mixed warnings and reassurances: It might get bad but it’s no big deal now; we’re preparing just in case but the public doesn’t need to worry about it. That should have been signal enough for companies and nonprofits to do things like this:

• Update their pandemic plans and decide which elements to implement now.
• Cross-train employees as a hedge against pandemic absenteeism.
• Build an organizational stockpile of personal protective equipment.
• Decide which operations can be shut down in a crisis, which can be run from home or other remote locations, and which must be sustained onsite despite the risks.
• Alert employees to the preparations they might want to be making at home, such as thinking through childcare plans and stockpiling medicines and other supplies.
• Start planning social distancing measures and other ways of operating more safely during a respiratory disease outbreak.
• Brief all stakeholders and especially employees on what the organization is doing to prepare, and what it expects to do if a severe pandemic materializes.

I’m not sure why so little of that happened. Most companies and nonprofits entered the crisis phase of the pandemic having done next to nothing during the “warning” pre-crisis months to prepare.

Are organizations beginning to get it right?

Organizations that aren’t front-and-center in the pandemic (the way hospitals and nursing homes are, for example) need to balance three priorities in both their communications and their actions:

Priority One is surviving. They can’t do any good for anyone if they go out of business. I’m sure organizations haven’t forgotten to think about their own survival, but I wonder if some have forgotten to communicate sufficiently about it. Employees worried about their jobs might worry less if they knew more about what their employers were doing to keep the organization alive.

Priority Two is helping. I am not generally a fan of Corporate Social Responsibility. I think companies should usually ground their actions and communications in “responsiveness” (doing what their stakeholders expect of them) rather than “social responsibility” (doing what they themselves consider good for the society). But in crisis situations the two come together: More than in ordinary times, stakeholders want to see organizations finding ways to help – whether it’s manufacturing ventilators or delivering meals. I think many organizations are getting this right, and those that aren’t will pay a price down the road.

Priority Three is the toughest: balancing concerns about COVID-19 infection with concerns about everything else we hold dear, from jobs to freedom to mental health. Many of our most visible leaders and communicators have so far failed this balancing test. Some failed in one direction and some in the other. For at least the next couple of years, the New Normal will be all about balance: living with SARS-CoV-2 (the virus that causes COVID-19); resurrecting our economy and way of life while protecting the vulnerable and keeping hospitals from getting overwhelmed. The same balancing act will be required within every organization – finding ways to do what you do while being neither cavalier about the virus nor obsessed with it. Very few of us are getting this right yet.

There seems to be only 2 ways to view this – either “science” or as the “economy.” How do we work in ways that don’t ask people to choose a side, like one is right and the other wrong?

I hate it when officials claim to be adhering strictly to “The Science.” COVID-19 science keeps changing and is hotly debated. Moreover, the key pandemic management questions go far beyond science. “How safe is safe enough?” isn’t a scientific question. Neither is how best to balance saving the most lives and saving the most of our way of life. These are political questions in the best sense of the word – questions officials need to answer with due deference to the interests and opinions of the body politic (that is, the public). Officials who aren’t listening to scientists are irresponsible. So are officials who give scientists their proxy.

And officials who quite properly pay attention to their constituents while claiming they are guided solely by “The Science” are dishonest.

Economic concerns and health concerns are inextricably linked – in both directions. The health impacts of lockdown and economic devastation are huge: depression and suicide, addiction, domestic violence, etc. Poverty and chronic anxiety are known killers. It is equally true that you can’t resurrect the economy if people are afraid to shop or go to work. So managing the COVID-19 pandemic is crucial to economic revival, and reviving the economy is crucial to public health.

And neither is possible without effective communication. If people don’t believe their officials can manage the pandemic adequately, they won’t fully reenter the economy. If people don’t believe their officials can do what it takes to resurrect the economy, their health will suffer, and so will their willingness to comply with social distancing strictures.

CNN and MSNBC routinely tell us what the administration is doing wrong. What if anything is the administration doing right?

Pandemics are global by definition, but pandemic viruses reach different communities at different times in different intensities – so pandemic planning has always been all about “targeted and layered” local interventions in response to local conditions. President Trump was right to see COVID-19 as something to be managed mostly by governors and mayors and their state and local health departments.

Some pandemic-related tasks needed to be federal: building test capacity; manufacturing and distributing personal protective equipment; managing the search for vaccines and therapeutics; distilling research findings into actionable guidelines. These tasks were carried out with vastly more controversy and turmoil because of dysfunction in the executive branch. There were obvious failures and insufficiently recognized successes. The most unarguable failure: uniting the country through determined, informed, empathic leadership in the White House.

The main thing the Trump administration did right was to leave state and local authorities in control. Somehow we blundered anyway into a nearly nationwide lockdown – a lockdown that probably made sense in places where the virus was already spreading explosively but was by definition excessive in places where less extreme “targeted, layered” measures could have done the job. Many states seem to be doing better at addressing local conditions in their criteria for coming out of lockdown, though I can’t tell yet how successfully they will identify and respond to clusters and resurgences.

Different state and local leaders are excelling and failing at different aspects of pandemic management. I wish contact tracing capacity were further along than it is. I wish more had been done to protect people in nursing homes and other congregate settings. And in my own area of expertise, risk communication, I wish state and local leaders were doing more to help their publics find the right balance between avoiding infection and other priorities.

But responding to the pandemic is rightly their job. And for all his bluster, President Trump has mostly left them to it. Now if he’d only stop undermining their efforts by continually urging his followers to go ahead and flout their precautionary guidelines and orders.

How has the CDC handled it?

The CDC’s biggest failure was not pulling out all the stops to make sure the U.S. had an adequate COVID-19 testing capacity as early as possible. The agency chose to develop its own test, and for crucial weeks its test didn’t work properly. It compounded the problem by not having a backup plan; not adopting another country’s test; and not pushing the FDA to allow states, hospitals, and private labs to develop their own tests. And to date it has never apologized for the testing debacle.

I think this debacle set the stage for everyone to single out the CDC for blame about other things that weren’t necessarily its fault. Pretty much the entire public health establishment was vehemently opposed to people wearing masks in ordinary life until suddenly (long after asymptomatic and pre-symptomatic spread was a known problem) it was just as vehemently opposed to people not wearing masks in ordinary life. That reversal is usually, unfairly laid at the CDC’s door.

On the question of how COVID-19 is transmitted, there was no reversal. The CDC has consistently said the main mode of transmission is probably droplets, but other modes – aerosols and surfaces – may sometimes play a role too. Early on, the CDC’s point that “surfaces may sometimes play a role” was often distorted by local officials and doctors into “touch is the main route of transmission, which is why handwashing is so important and masks are so useless.” For a long time the CDC did nothing to disabuse people of this misimpression. Then after public health did an about-face on the advisability of wearing masks, the CDC’s basically consistent assessment of transmission pathways started to be distorted in the other direction. “It’s probably mostly droplets” was interpreted as “the CDC says surface transmission doesn’t happen after all.” And then when the CDC tried to clarify again that “surfaces may sometimes play a role” in transmission, some commentators threw up their hands and concluded that the CDC keeps reversing itself and should just admit it hasn’t a clue.

It didn’t help that the CDC visibly lost the confidence of President Trump. The testing debacle undoubtedly contributed to that, but the key moment came on February 25, when the CDC’s Nancy Messonnier warned the media that because of COVID-19, “disruption to everyday life may be severe.” She apparently didn’t ask the president’s okay, didn’t even give him a heads-up. The stock market tanked, and so did the CDC’s standing with the White House.

Despite all of the above, the CDC continues to be an indispensable source of guidance to state health departments, governors, clinicians, industry sectors, etc. Though the White House no longer lets the CDC do COVID-19 press briefings, the agency still does just about everything else it has done in past public health emergencies.

How often does the White House alter or block CDC guidance documents? It’s hard to tell. I used to work fairly closely with the CDC, closely enough to know sometimes when its draft documents didn’t survive White House scrutiny unscathed. Now I find out with everyone else when hostile media get the story. I don’t entirely trust my impression that this administration censors the CDC more often and more harmfully than prior administrations. But some of the specific instances that have found their way into the news are abhorrent and terrifying. The CDC’s recent advice on ways to make worship services safer, for example, was rewritten at White House insistence to delete the point that choirs and other group singing may be a source of COVID-19 transmission. (I suppose you could argue that this was a win-win. The President signaled his support for churchgoers, and thanks to the controversy vastly more people learned that group singing is dangerous. It’s still abhorrent and terrifying.)

The toughest question is whether the CDC brass is self-censoring. When your organizational reputation is in tatters and your boss doesn’t have your back, it’s got to be hard to make yourself tell unpopular and unvarnished truths.

What do you advise states to do in response to protests at state capitals?

I am writing these answers as cities around the country explode in the wake of the George Floyd killing in Minneapolis. The images of riots from the past four nights make the most outrageous of the anti-lockdown demonstrations look almost law-abiding by comparison.

As a risk communication consultant, I have always told clients that safety trumps outrage management. My mantra: If you are threatened, call the cops. If you feel threatened, call the cops. If some of your staff or some bystanders or even some demonstrators feel threatened, call the cops. If you think maybe you should call the cops, call the cops. Things get more complicated, obviously, when the cops are part of the problem and calling the cops is likely to exacerbate the violence. But the principle is unchanged: Safety comes first.

Even when safety isn’t an issue, it is still an open question whether there’s anything officials can usefully do in response to anti-lockdown protests. Often the protestors have zero interest in any official response. They are there to get their opinions and feelings covered by the media. Any official who tried to launch a dialogue would immediately become a foil for their scripted, media-savvy monologues. Better to let them exercise their First Amendment rights without you.

But sometimes protestors are open to dialogue … sometimes even when they didn’t plan to be. Yesterday I watched in awe as Atlanta Police Chief Erika Shields made unexpected dialogue happen with demonstrators enraged at the George Floyd killing.

For times when you think dialogue is possible, here is the fundamental initial strategy for mitigating a crowd’s outrage. It has three steps:

• First let them vent – as long as they want. Listen. Resist the temptation to respond. In fact, the first few times they ask for a response, demur: “I’m here to listen and learn. I have plenty of other opportunities to say what I think. There are people here who haven’t spoken yet.”
• Eventually the crowd will start shushing each other and demanding to hear from you. Start by echoing what you heard. Try to echo faithfully, especially the parts you consider wrongheaded (even the insults against you personally). Don’t assume you understand. Don’t claim you understand. Ask if you understand: “Let me see if I’m hearing you right. Here are the three main grievances I think I heard….”
• Then find aspects of what they’re telling you that you can honestly agree with. Don’t pretend to agree with points you think are wrong, but don’t debate those points either. Focus on opinions and feelings you share. The claims of protestors are just about always a mix of truth, exaggeration, and crap. Don’t rebut the crap or correct the exaggeration. That’ll come. It has to – but not yet. Park their crap and exaggeration in a mental parking lot, and validate their truth.

This “Outrage Management 101” protocol can’t resolve a controversy, of course. At best it opens up a calmer dialogue and thus a chance to resolve the controversy. Its main disadvantage is that equally impassioned people on the other side won’t like watching you “placate the crazies” (as they’ll see it) – or even worse, join them! I think this is a price worth paying. Little by little, all sides will figure out that you’re a leader who listens and learns from everybody.

If Trump has been more aggressive early on, don’t you think the same critics who say he didn’t do enough would be claiming he was using scare tactics to gain power?

Trump did make one aggressive move early on: He stopped nonresidents from entering the U.S. from China. This violated the public health shibboleth that travel and trade should not be impeded to prevent or slow the introduction of infectious diseases. And so Trump was excoriated at the time. The left called the measure racist and xenophobic, and most public health officials called it ineffective. There is now something approaching an unspoken consensus that it was probably wise, albeit insufficient.

Political leaders often see crises as a reason (or excuse) for seizing or consolidating power. For better or for worse, that’s what many national leaders around the world did vis-à-vis COVID-19. It’s also what some U.S. governors did. But not Trump. Many had feared and some had welcomed what they saw as Trump’s megalomania; the left called it fascism and the right called it the unitary executive or draining the swamp. But despite frequent empty threats to force X or require Y or overrule Z, in practice Trump ran away from power over COVID-19. He coveted the attention but not the accountability. He performed control but declined to actually take control over anything except the performance itself – the communication activities of federal officials. Nearly all the key decisions – testing, PPE, lockdown, coming out of lockdown – were left to the states.

So we watched critics who had spent three years complaining about Trump’s dictatorial tendencies demanding that he be more of a dictator: No more patchwork of inconsistent state standards! Invoke the Defense Production Act! Centralize! Tell us what to do!

As your question suggests, I do think a more aggressive early response to COVID-19 from the Trump administration would have been attacked by critics. In fairness, this is only partly because Trump’s critics are predisposed to attack anything he does. It’s also because Trump seems likelier than many other chief executives to have chosen his aggressive responses unwisely, implemented them inconsistently, and explained them incoherently. And it’s because even the best leaders get pushback when they try to respond aggressively to a threat before it’s visible (much less vivid and scary) to the rest of us.

What do you make of the ads now appearing on TV that say that companies are really about helping us “in these difficult times”? They all sound exactly alike. Is it credible when luxury brands to tell us this?

As I noted in #4, these ads do indeed sound alike: “We’re all in this together; we salute the heroes on the front line; here’s how our company is stepping up,” as you say, “in these difficult times.”

I’m not a marketing expert, but my best guess is that these ads are the wisest course. Crises arouse communitarian feelings and actions; most people really do have more empathy for each other now than usual. We’re also more anxious than usual – and that anxiety morphs easily into explosions of disproportionate anger at anyone who violates a COVID-19 communitarian norm: a shopper not wearing a mask; a government official taking a pleasure trip; a celebrity hosting a party.

An ordinary product advertisement could easily strike people as such a violation: “Haven’t you noticed the world has changed? Everybody’s struggling to keep our heads above water and you’re urging us to buy WHAT?” Disappearing entirely isn’t a viable brand management strategy either. So the best course of action is to do what most companies are doing: Signal your own communitarianism – your awareness that times are tough, your admiration for those who have risen to the occasion, your determination to do your part. By all means show the public what your company is actually doing to help – but cautiously, modestly, with nothing even close to boastfulness or exaggeration.

In time, I suspect, the companies that made truly herculean efforts to help will stand out, and so will the companies that did little or nothing. But it won’t be their ads that tell us which are which.

How much genuinely important information does it seem that the administration has withheld? You have also written that government routinely misleads the public and gets away with it, where CEOs would not. You mentioned Ebola and Zika. Can you explain?

One of the things I learned consulting for corporations, governments, and activist groups is that “the good guys” tend to be more dishonest in their public communications than “the bad guys.” There are at least three reasons:

• Organizations that are trying to help save the world feel entitled to say misleading things in pursuit of their prosocial goals. Organizations merely trying to earn a profit don’t feel so entitled.
• Organizations that are trying to save the world are less likely to get caught in their dishonesties than organizations merely trying to earn a profit. Journalists and even prosecutors don’t scrutinize their claims as skeptically.
• When we learn that organizations that are trying to save the world have misled us, we tend to forgive them. When we catch profit-making organizations in the same sorts of misbehaviors, we tend to crucify them.

I have written a lot about the various dishonesties of public health “good guys” vis-à- vis infectious disease outbreaks (also vis-à-vis vaccination and other measures aimed at fighting infectious diseases). I’m not going to try to summarize all that here. A good place to start is my notes for a 2016 presentation, “U.S. Public Health Professionals Routinely Mislead the Public about Infectious Diseases: True or False? Dishonest or Self-Deceptive? Harmful or Benign?”

You ask how much genuinely important information about COVID-19 “the administration” has withheld. I assume you mean the federal government – and the answer is I don’t know. It’s hard for me to imagine a piece of genuinely important information about the pandemic that the federal government would be able to withhold. Distort? – absolutely. Spin? – you bet. Ignore? – endlessly. But withhold? Then again, if the federal government had an important piece of information it successfully withheld, how would I know?

President Trump has certainly said a lot of false or misleading things about COVID-19; Drs. Fauci, Birx, and Redfield have said some too. At least some of the time, they have to have known what they were saying was less than candid. But I’m sadly used to politicians and public health officials being less than candid about infectious disease outbreaks. When I look closely at the public statements of governors and mayors, or of state and city health departments, I see plenty of examples of less-than-candid pandemic communication. The Trump administration is worse than most, but far from alone.

Here’s one example among many. After a badly over-reassuring start, New York Governor Andrew Cuomo became something of a role model of how a government official can say alarming things in ways that are candid yet somehow comfortingly empathic. But he has been neither candid nor empathic (nor apologetic) about his biggest mistake: sending elderly COVID-19 patients to nursing homes when they no longer needed hospital care, even though many were still infectious. This undoubtedly contributed to New York’s horrific nursing home death toll. Instead of owning the policy blunder, Cuomo tried to blame the federal government (he said he relied on a CDC recommendation) and the nursing homes themselves (he said they could have refused). New York also understated the disaster by changing how it counted nursing home deaths so infected nursing home residents who were transferred to a hospital before they died were no longer included in the total.

In the early days of COVID-19, it is clear that the Chinese government really did withhold some important information. I think Chinese transparency about COVID-19 was probably an improvement on Chinese transparency about SARS nearly two decades earlier. But that is a very, very low bar.

You said on 2/9 [Link launches an MP3 audio file.] that “outlier” opinions are “healthy” even though they are “almost always wrong.” Can you explain? And what is to CNN an outlier opinion is to Fox a suppressed truth – and vice versa.

In an idealized version of science, each scientist makes up his or her own mind independently, based on the evidence. It’s obvious why outliers are usually wrong: They’re looking at the same evidence as their colleagues and reaching a weirdly different conclusion. Once in a while convincing new evidence emerges that supports an outlier’s judgment. When that happens, mainstream scientific opinion changes, not in response to the outlier but simply in response to the new evidence. Even in this idealized situation, outliers add value, since they are likelier than mainstream scientists to pursue obscure hypotheses that lead to surprising conclusions. But once the evidence emerges, the surprising conclusions speak for themselves.

In the real world of science, groupthink plays a major role. Except in their own tiny “micro-field,” scientists don’t independently assess the evidence. They’re not experts in all of science. They’re “experts” in what the real experts think – experts in whom to trust. So mainstream scientific opinion isn’t formed by thousands of scientists independently deciding X is true. A much smaller group of scientists, most of whom have known each other for decades, agree that X is true, and the rest figure they must be right.

Along comes an outlier who thinks X might be false. The outlier is usually an outsider as well, not a member of the small group of experts who set the standard for mainstream scientific opinion on that particular question. Understandably, the outlier may have a tough time getting heard – a tough time getting grants (so outlier hypotheses might not get properly tested) and a tough time getting published (so outlier findings might not get properly noticed). The core experts have a reputational and psychological stake in not changing their minds. The rest of the scientific mainstream has a reputational and psychological stake in not allying with a crank. And so, as Thomas Kuhn and Karl Popper famously documented, scientific paradigms resist change.

Even though the core experts are likelier to be right than the outliers, science needs aggressively outspoken outliers for the times when the core experts are wrong. The most valuable outliers are those who somehow manage to be insiders at the same time, keeping the mainstream’s respect even when they diverge from the mainstream’s consensus. (Michael Osterholm of the University of Minnesota Center for Infectious Disease Research and Policy is a sterling example.) But to a lesser extent, every scientist who is occasionally willing to buck the trend and publicly think the unthinkable adds value. Each individual iconoclast is probably wrong. But the more iconoclasts we have, and the more we force ourselves to take their outlier opinions seriously, the more self-correcting science will be.

And outlier opinion is never more needed than when an important new scientific conundrum emerges, such as a novel pandemic virus. Under pressure to come up quickly with judgments and recommendations, the mainstream is all too likely to coalesce prematurely around conclusions that are plausible but far from definitively proven. Under those circumstances, outliers are likelier than usual to turn out right.

How does your Risk = Hazard + Outrage formula apply to this crisis?

I distinguish a risk’s “hazard” (how much harm it’s likely to do) from its “outrage” (how upset it’s likely to make people). Based on this distinction, I categorize risk communication into three tasks [Link launches an MP3 audio file.]:

• When hazard is high and outrage is low, the task is “precaution advocacy” – alerting insufficiently upset people to serious risks. “Watch out!”
• When hazard is high and outrage is also high, the task is “crisis communication” – helping appropriately upset people cope with serious risks. “We'll get through this together.”
• When hazard is low and outrage is high, the task is “outrage management” – reassuring excessively upset people about small risks. “Calm down.”

Before a crisis, the main risk communication challenge is precaution advocacy. People are unaware of the potentially impending disaster or complacent about it. You’re trying to warn them to prepare, emotionally as well as logistically.

COVID-19 precaution advocacy was woefully inadequate. Even experts who saw the pandemic risk clearly were mostly unwilling to shout it from the rooftops. They were afraid of being mocked, ignored, or criticized. And they were afraid of turning out wrong if the threat fizzled.

During a crisis, obviously, everything focuses on crisis communication – guiding people through the awful situation they’re in and helping them make wise rather than unwise decisions about how best to protect themselves.

COVID-19 crisis communication has been spotty. I think a lot of experts tried to compensate for their insufficiently alarmist precaution advocacy with excessively alarmist crisis communication, leading to lockdowns even in places where less extreme social distancing interventions (like canceling mass gatherings) probably would have been sufficient. Other leaders made the opposite mistake, insisting that the risk was low long after it was obviously high. But I have a collection of excellent examples of COVID-19 crisis communication too. And the crisis isn’t over. Sadly, there will be plenty more opportunities for excellent COVID-19 crisis communication.

After a crisis, the main risk communication challenge is outrage management – addressing criticisms and recriminations about how the crisis was anticipated and handled. As a rule, people hesitate to voice those criticisms and recriminations mid-crisis; they don’t want to attack the leaders they’re relying on to protect them. In fact, I have sometimes written that when criticisms and recriminations come to the fore, that’s a signal that the crisis is ebbing.

COVID-19 is different in ways that complicate the usual pattern. Pandemics happen in peaks and waves. So in places where the COVID-19 pandemic is ebbing, it may well be ebbing only temporarily. During the lull, outrage management is coming to the fore as if the crisis were over – but there is need, too, for precaution advocacy to warn people that it’s probably not over. And in other places, the first wave hasn’t yet arrived so the paradigm is precaution advocacy; or infections are still peaking so the paradigm is crisis communication. Also, we are arguably undergoing two simultaneous crises, the pandemic crisis and the lockdown crisis. People who believe their leaders are focusing on the wrong crisis can’t afford to wait till the crisis ebbs to voice their outrage; they have no choice but to mobilize outrage now.

What, as a society, have we learned from this episode so far?

So far, I think, the main thing we have learned – or relearned – is that everything is unpredictable and fragile. Whatever your life was like a few months ago, it is profoundly changed today in ways you couldn’t have guessed. As for what your life will be like a few months from now or a few years from now, there is no way to guess that either. All you know for sure is that it will be vastly different from the way it was a few months ago.

What will we have learned by the time the pandemic truly ebbs? A little of what I’ve heard predicted:

• That authoritarian governments manage crises better than democracies?
• That cities that get too big and too crowded are now too dangerous and essentially unlivable?
• That huge investments are needed in global health and pandemic preparedness?
• That offices are a thing of the past and working from home is the future of most “office” jobs?
• That we really are all in this together and need to nurture more communitarian values?

I have no idea if these are good guesses about what we will ultimately have learned from the COVID-19 pandemic.

What have you personally learned from it? How, if at all, has it changed your thinking?

I have spent decades teaching clients that panic is rare – and in the early weeks of the pandemic, public complacency was (as usual) a hugely bigger problem than public panic.

In crisis situations, people very seldom panic. We may get frightened – sometimes appropriately frightened, sometimes excessively frightened. Or we may fail to get frightened, even when it would be appropriate and useful to do so, since fear motivates precautions and preparedness. But we don’t panic. If we feel panicky and can’t bear the feeling, we trip an emotional circuit breaker and flip into denial instead.

But now I’m wondering if public health officials and experts panicked.

In decades of pandemic planning, I never once saw anyone propose nationwide lockdowns as an appropriate response. Social distancing, yes. Even “extreme social distancing,” such as canceling mass events and closing schools. But locking down entire countries’ economies? Never. The mantra was always “targeted and layered” responses to local conditions. The goal was to “flatten the curve,” so the same inevitable number of people got infected, but not all at the same time. The goal of that was to keep hospitals from being overwhelmed, so they could prevent the deaths that were preventable, whether deaths from the pandemic virus or deaths from heart attacks, strokes, and car crashes.

The thinking was that there was no way to keep pandemics from continuing to infect people until herd immunity was achieved (whether through infection or vaccination). You couldn’t stop a pandemic virus. So three goals made sense:

• Keep the most vulnerable people as isolated as possible, so they aren’t the ones who get infected – and eventually herd immunity will protect them.
• Expect not-very-vulnerable people to get infected and (in most cases) recover, so you progress toward herd immunity and maintain your economy in the meantime.
• Use social distancing and other measures to spread out the infection rate, so hospitals stay functional and can treat those who get very sick – thereby reducing the pandemic’s death toll though not its eventual total case count.

Lockdown wasn’t in the playbook. Certainly locking down places where very little virus was circulating and hospitals had plenty of surge capacity wasn’t in the playbook.

So how did we get lockdowns throughout the U.S., most of Europe, India, and elsewhere? The public didn’t panic. The public was compliant – surprisingly so, often reluctantly so, and now decreasingly so. Politicians made the decisions, of course. But public health experts and public health officials gave the advice. I am not a public health expert or official. But it looked to me at the time like most lockdowns in most places were panic-driven bad advice. It still looks that way to me now.