- Denial is a natural human response when we are faced with a situation that evokes overwhelming emotion and panic, like the coronavirus pandemic.
- Experts weigh in on how to convince Americans that the coronavirus pandemic should be taken seriously and to follow CDC and WHO guidelines to prevent the spread of the virus.
- Experts say that people need to be given the big picture of how the repercussions of non-action against COVID-19 will affect the country as whole, not how the virus will impact an individual.
- Detailed information is also more helpful in stemming from fear of the unknown, which is especially difficult in the current situation as there is still a lot of information about the virus that experts don't know.
In Utah, where popular travel destinations have rapidly devolved into COVID-19 hotspots, residents are posting photos of themselves at restaurants and parties to protest what they view as an assault on their constitutional rights.
Irrational as this may seem, health-communications experts say denial is a natural human response to overwhelming emotion and panic. It's so natural that even trained physicians have questioned the outbreak.
"At the beginning of the epidemic in Italy … a couple of colleagues of mine whom I admire and have great respect for were in complete denial," Elena Savoia, deputy director of the emergency preparedness program at Harvard's T.H. Chan School of Public Health, told Business Insider in an email.
"We had only a few cases at that time in Italy and they were … skeptical about the need to prepare and get ready for a massive number of cases," Savoia said. "This happens frequently with professionals that are not trained in preparedness."
But now that the US is the nation with the highest number of COVID-19 patients, time is running out to convince the skeptics.
Helping people confront the consequences of their actions
To avoid overwhelming the nation's healthcare system, experts say, Americans need to be convinced to stay home. That's going to require breaking through the skepticism and the fear of the unknown — no small feat when dealing with a new virus even the experts know little about.
What Americans need to hear is not a debate about how deadly or dangerous COVID-19 is to individuals, but about the consequences if a surge of cases surpasses our medical system's ability to treat patients, Savoia said.
Because when the number of patients exceeds the number of available hospital beds, patients in need of medical treatment — even for unrelated conditions — may be unable to access it, resulting in otherwise-preventable deaths.
"We are already seeing elective surgeries being canceled," Savoia wrote. "We need to make people understand that the behaviors we adopt now will have an impact on our own freedom and health, even if we are lucky and we are not getting COVID-19."
Misinformation and conspiracy theories aren't the main threat — fear is
Misinformation and conspiracy theories about the novel coronavirus are certainly out there. However, they don't appear to prevent Americans from getting a clear message about the risks associated with COVID-19.
In a survey conducted in early March by Pascal Geldsetzer, an instructor in the primary care and population health division at the Stanford University Department of Medicine, nearly 6,000 online respondents (half in the US and half in the UK) demonstrated sound knowledge of the disease.
- Nearly 80 percent of US respondents could list the primary symptoms of COVID-19 — cough, fever, and shortness of breath.
- More than 90 percent accurately described the main steps necessary to prevent the disease, though nearly half also listed ineffective strategies such as rinsing your nose.
- When asked what percentage of COVID-19 patients would die, respondents estimated about 5 percent, which probably only slightly overshoots the mark, Geldsetzer told Business Insider.
But the kicker to Geldsetzer's examination is that US respondents went awry when estimating the potential impact of the disease: More than half said they thought COVID-19 would kill less than 500 people in the US and UK by the end of 2020. Already, thousands of people in the US, alone, have died from COVID-19.
Despite accurate information about the disease, this inability to estimate the scale of the crises may be rooted in a fear of the unknown. When we encounter uncertainty, we tend to either panic, or cope by entering a state of denial.
This is why talking about COVID-19 is so difficult, according to Savoia. Even the top medical experts don't know the answers to key questions like how deadly the virus is, or how easily it spreads. Without concrete information, Savoia said that many people have clung stubbornly to their denial.
"In Italy, they have used terms such as 'we are at war, you need to stay home,'" she said. But using fear-laced language triggers a strong emotional response, which could cause listeners to either panic or ignore the messenger. "They will be overwhelmed by their emotions and unable to process the details of the message."
Give it to them straight
Terry Adirim, senior associate dean of clinical affairs at Florida Atlantic University's College of Medicine, was part of the team informing and updating the public during the H1N1 outbreak in 2009. She said that leaders, communicators, and even social media users need to focus on conveying accurate messages about COVID-19 in a calm and direct manner.
"Be direct, be honest, be transparent, and communicate frequently," she said. "You can't overcommunicate. People are hungry for information."
In particular, she said, people want concrete, specific information, not vague estimates. For example, saying that the pandemic could trigger closures that last for weeks or even months causes unease. But adding concrete details — for example, that past pandemics suggest controlling COVID-19 will require eight to ten weeks of isolation, Adirim said — helps calm anxiety.
If the answer to a question is unknown, Adirim said, be honest about that, too. Don't guess or attempt to gloss over the risks, because that can undermine your credibility. The same rules apply on social media, she said.
But Adirim cautioned that in online exchanges, it's especially important to verify the source and truth of information before sharing. When you do share, she said, always cite your source so others can verify.
Once the facts are on the table, communicate how the crisis impacts individuals, without exaggerating or resorting to scare tactics. Talk about what's going on in the hospitals, about someone you know who got sick, or about how people who get sick may not receive treatment if the virus spreads too quickly.
"You need to make it personal," Adirim said. "You have to make it real for people."
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