In other cases, leaders rallied the public around a shared experience and communicated the need for collective sacrifice to break the cycle of transmission, expressing empathy with their constituents in this challenging time. However, their empathetic communication was contradicted by their actions. California Governor Gavin Newsom attended a large party shortly after communicating to California residents the need to avoid large gatherings, even as many families had hoped to do so around the holidays.60 Denver Mayor Michael B. Hancock urged the public to avoid traveling for Thanksgiving, empathizing that many people would miss time with family as a result, and then flew across the country for his own personal holiday travel.61 Both officials acknowledged the contradiction and failure to abide by the same expectations they had communicated to the public, but their actions damaged credibility and reinforced public perceptions that political elites were held to different standards than the general public with whom they claimed to empathize.
Promote Action
In addition to providing information, crisis communication must include clear, concise, and concrete actions for the public. Emotions run high during emergencies, particularly when facing new threats, and offering people meaningful steps to take may help provide a sense of control in protecting themselves and others.10, 25 CERC highlights the importance of these clear, concise messages about what actions should be taken.25 In some situations, offering a range of actions may be most impactful: maximum, moderate, and minimum responses.62 Public health messaging during this pandemic has included full stay-at-home orders (maximum); guidance to wear masks, avoid public transit and crowds, and practice social distancing and hand hygiene (moderate); and if those are not all feasible, to at least practice social distancing and hand hygiene (minimum). Critically, communications to promote actions should highlight their benefits and importance.
Several state and local leaders demonstrated effective application of this principle. Maryland Governor Larry Hogan and Baltimore City Mayor Bernard C. “Jack” Young convened weekly press conferences that consistently included specific, simple actions the public should take to protect themselves and help mitigate the virus’s spread. In July, as he expanded the state’s mask order, Governor Hogan empathized with residents of Maryland while emphasizing the importance of wearing masks and the science behind the order.63 Clear messages with a simple, concrete action can help empower individuals to protect themselves and provide a sense of control.25 Unified, apolitical messaging around these actions is also crucial to avoid actions taking on a partisan spin. Early in the pandemic, Republican governors in generally “blue states” (eg, Governor Hogan and Governor Phil Scott of Vermont) demonstrated the importance of a collective crisis response that bridged the political aisle, noting, for example, that wearing masks should not be a political statement.63, 64
Show Respect
With the high level of uncertainty in an emergency context, respectful communication is paramount. With many unknowns about COVID-19, including its long-term effects and what comorbid conditions pose the greatest risk, the public has continuously experienced high levels of uncertainty about prevention, treatment, and care, which have been amplified as vaccine candidates and potential rollout strategies have been announced. Respectful communication promotes cooperation and rapport and engages and values community inputs, all of which are essential to promote adherence to public health recommendations.
In late 2020, as 3 COVID-19 vaccines released Phase 3 clinical trial data demonstrating safety and high efficacy, authorities moved forward with planning for distribution. State and federal leaders were tasked with communicating to the public about the phases of vaccine availability, which prioritized healthcare workers, long-term care residents, other frontline and essential workers, and individuals at highest risk of infection and severe illness. However, many of these communities have experienced historical trauma associated with public health and medical interventions and have also faced disproportionate health and economic impacts from current COVID-19 restrictions.65 They have, understandably, expressed concerns and mistrust with the expectation to receive what they view as a largely experimental vaccine before the general public, particularly as other basic needs are not necessarily being met.
Communicating about the safety, efficacy, and importance of vaccination and the rationale for prioritizing these populations is a new, complex challenge for public health authorities.66, 67 The long history of racist and unethical practice by government authorities and medical institutions in these communities has led to high levels of vaccine hesitancy. As we begin the largest vaccination campaign to date in the United States, leaders can and must show respect by recognizing the validity of vaccine hesitancy in these situations and being responsive to community concerns.
By acknowledging and acting on other concerns beyond disease control, authorities demonstrate respect—following through with concrete, responsive action is crucial for this principle. Several states and localities include small business owners and community leaders on their COVID-19 task forces and initiated targeted initiatives to support marginalized and minority communities.68, 69 In Washington state, these commitments have been accompanied by funds to local community organizations and partners.70 Authorities have also incorporated messaging about where to access basic
