Panic is never a good public health strategy, but in attempting to preemptively tamp down public fear, I think experts are failing to learn one of the most important lessons of Covid-19: that we’re too afraid of “alarmism” when outbreaks hit, and should spend less time telling people not to overreact and more time telling them what’s actually going on.
The impulse on the part of the public health community to try to manage public emotion — rather than provide the public with facts — has dogged us throughout the pandemic, often making it harder to make good decisions. Assurances that people didn’t need masks, meant to protect the supply for health care workers, lastingly damaged trust and masking rates. The CDC’s initial decision not to track breakthrough infections — seemingly meant to show confidence in the vaccines — made it harder to tell how long vaccine-based immunity lasted…
Experts should focus more on communicating what they know about monkeypox, pandemics, and the fragility of our current system, aiming to tell people what they can do and the policies they can support in response to their justified fear — instead of preemptively warning against “panic.”
…The course I’d like to see them take instead is the one Sandman, the risk communications expert, recommended with Covid-19: “Instead of deriding people’s fears about the Wuhan coronavirus,” he wrote, “I would advise officials and reporters to focus more on the high likelihood that things will get worse and the not-so-small possibility that they will get much worse.”
…Many of the biggest missteps of the last few years have happened when our public health and communications institutions have tried to manage public reactions to what they have to say: from Fauci saying that he dismissed mask-wearing early on in the pandemic out of fears of causing mass panic, to worries that endorsing booster shots (even as the evidence grew they were needed) would make the vaccines look bad, to the FDA’s earlier seeming reluctance to authorize vaccines for children under age 5, despite data justifying it, out of concerns that authorizing Pfizer and Moderna at different times would confuse the public.
In general, I’d like to see public health officials step back entirely from trying to manage our feelings about outbreaks. Don’t tell us to worry or not to worry, or not to worry yet. Don’t tell us to worry about something else instead. Tell us what measures are being taken to contain the monkeypox outbreak, and prevent the next monkeypox outbreak, and prevent the next outbreak of something much, much worse than monkeypox. By all means, explain the reasons to think monkeypox is likely not very transmissible; that’s important information you have relevant expertise on, unlike trying to manage the public’s feelings.
And for its part, the media should stop asking public health officials “should I worry?” instead of asking them the questions they are much more equipped to answer: What policies would have prevented this outbreak? What measures need to be in place to contain it? What scenarios are plausible from here?
As I noted earlier this week, we’re not preparing for the worst in terms of monkeypox surveillance. Failing to learn the lessons of the COVID pandemic does not prevent panic, and arguably leads to more panic, one way or another.
We also need to start laying out scenarios for ‘increased concern.’ A critical one would be multiple cases that can’t be linked epidemiologically (akshually, that’s pretty close to kinda panic time…). Of course, if our surveillance is poor, then we’re more likely to miss those intermediate cases.
Anyway, rather than playing eleven dimensional chess, just level with people. Yes, there will be assholes, but assholes gonna asshole. But we’ll get a lot more trust if our leadership is honest.