12 December 2020, Manchester UK Freedom Rally protest by Piccadilly Gardens. Credit: John B Hewitt.

SPIN DOCTORS

Health Agencies and Information Overload

In 2019, the Global Health Security Index scored the United States as the most prepared country to respond to a pathogen outbreak. Yet health agencies have struggled to guide the public’s response to the pandemic because they have erred on the side of unfiltered transparency, hoping that people would form their own pandemic precautions around the science. But an overload of information blurs the best of messages, leading to false information, confirmation bias, and politicization.

Health regulators struggling to manage the politics of the pandemic is not unique to the US: populist leaders across the world used nonpartisan health regulations as fuel for misinformation. Distrust in health regulations has caused thousands of preventable deaths, suggesting that chaotic messaging is just as deadly as a virus.

The proven effectiveness of vaccines has done little to stem the power of vaccine hesitancy. Researchers have been investigating coronavirus vaccines since the 2002 SARS outbreak; still, even the most researched emergency drug is bound to have unanticipated miscalculations. Reevaluating data does not necessarily mean a drug is dangerous, but the window of opportunity to reassure an anxious country that the drug is safe is short.

Peoples’ mental bandwidths are already overloaded. Our information burnout lets the loudest voices (public or private) poison pandemic guidance because their messages preserve listeners’ way of life. Worse, conspiracy theories seem legitimate on professional looking websites, validating even the wildest of hoaxes. Accessible online misinformation breeds confirmation bias among those who are already frustrated with pandemic precautions and seeking data to justify their beliefs.

"Assuming that people will give the scientific process the benefit of the doubt leaves too many doors open"

Consider the decision to pause single-dose vaccines. EU regulators stopped AstraZeneca jabs after some reports of blood clots, but found that the benefits of the vaccine far outweighed the risk. The US came to the same conclusion after pausing the Johnson and Johnson vaccine. Yet, what stuck was that the vaccines cause serious health problems. In the US, the Johnson and Johnson vaccine is still in circulation, but the country’s vaccination rate noticeably dipped since the pause and the country remains fiercely divided.

In the EU, the response was mixed. While the data was reviewed faster than in the US (three days versus ten days), several countries—France, Germany, Italy, Portugal, Spain—have yet to approve the Astrazeneca vaccine. The lack of unanimous approval—marking AstraZeneca as a second-class vaccine—and stricter vaccination requirements ignited protests across several countries: most recently, protests in Germany, France and the Netherlands have drawn the distasteful comparison between vaccination requirements and the Nazi regime. Although the US’ extended pause was a costly misstep, neither set of health regulators successfully explained a statistically insignificant link.

Investigating the link was the right step to take, but uncoordinated and overly-analytical regulatory responses reaffirms skeptics’ bias that the vaccines were rushed and are unsafe. Politics often drives how a problem is defined, so government agencies must recognize that science loses its impact if it cannot be communicated effectively. Misinformation quickly twists scientific procedures into propaganda, so even nonpartisan agencies must be conscious of public perception and use their vast expertise to coordinate a solution efficiently. Assuming that people will give the scientific process the benefit of the doubt leaves too many doors open and simply generates more distrust.

26 January 2021 Demonstrators clash with police in Rotterdam. Credit: Killian Lindenburg/MediaTV via EPA

Successful countries’ pandemic strategies have lifted, rather than weaponized, health regulators voices. Countries who saw the largest death tolls—US, Brazil, India, Peru, UK—framed the pandemic around a war and expected its people to fight something invisible with gobs of conflicting information. But combative language is fundamentally divisive because there is little room for error: either a weapon - such as vaccines - works or it doesn’t.

Effective pandemic strategies instead framed the crisis as a time for unity. Although this approach sounds just as vague as a war metaphor, it proved more effective because it set up clear roles for both the government and citizens. The government managed guidance and people followed the government because it acted as the primary source of information. While different healthcare infrastructures (and sizes) make it difficult to copy specific messaging campaigns, if the government does not claim its authority and expertise during a crisis, people will gravitate towards other sources that make them feel safe and justify their reactions.

With speculation rife about the Johnson & Johnson jab’s possible link to a rare nerve-degenerating disorder and booster shots becoming a reality, vaccine hesitancy isn’t a problem that is going to resolve itself. And as the fallout from the blood clot link shows, research does not reassure an exasperated and skeptical public when the messaging is chaotic.

Yet the answer is not to completely censor media outlets: this strategy is liable to backfire and plant more distrust in government agencies. Instead, the government must work to make itself a credible source of information by making messaging campaigns flexible enough to handle setbacks. One way is to define roles for the government and the public from the onset of a disaster. Just as importantly, government health regulators must recognize that they essentially act as politicians during a pandemic: how they spin setbacks influences the public’s reaction. Health regulators cannot let misinformation spreaders overshadow their expertise or else risk thousands of preventable deaths.