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The
Opportunities And Challenges Of Public Communication During The
COVID-19 Pandemic
A
Conversation With Vanderbilt University’s William Schaffner---A “Go
To” Communicator Par Excellence
During the COVID
pandemic, Dr Anthony Fauci from the National Institutes of
Health is undoubtedly the most frequently appearing expert on TV and
other media. Another much sought after spokesperson is Vanderbilt
University’s William Schaffner, an infectious disease and
epidemiology expert who served as an Epidemic Intelligence Service
officer at CDC and is currently Professor of Preventive Medicine in
the Department of Health Policy as well as Professor of Medicine in
the Division of Infectious Diseases at the Vanderbilt University
School of Medicine.
Bill Schaffner served
on the first advisory board for The Epidemiology Monitor and has been
a longtime supporter of the newsletter since it first appeared 40
years ago.
We wondered how Bill’s
science communication tasks and challenges have changed during the
COVID pandemic compared to communication challenges associated with
past public health problems and what insights he could share with the
epidemiology community. He did not hesitate in accepting our
invitation, and below are his candid remarks about his approach to
science, infectious disease, epidemiology and public health
communication with the public.
Epi Monitor:
How
did you come to play such an important and prominent role as the “go
to person” for the NY Times and other publications and multiple media
outlets on such a wide variety of science related topics?
Schaffner:
Well,
going way back to my youth, it's probably a theatrical production that
I could point to. When I was in college I was also involved in
theater. But then of course I put that aside when I went to medical
school. But I was always attracted to this form of communication.
When I joined the
Epidemic Intelligence Service at CDC I was assigned to the state
health department in Rhode Island, and while I was there the state
epidemiologist left to take another position. I became the “point man”
for local reporters, and I answered media questions about influenza,
salmonella and other topics. I came to see answering questions from
media as a teaching opportunity just as working at the bedside or in
the laboratory or giving a seminar was a teaching opportunity. Each
one of those venues has distinctive characteristics and opportunities
for teaching. Whether we are physicians or PHD’s, we are referred to
as “doctor”. This word derives from the Latin docere which
means to teach.
I do
think my predilection for performance and working in the college drama
group and now resurrecting some of that fun by working with
journalists helps explain how I ended up doing so much media work or
what I call “performance teaching”.
Epi
Monitor:
Well that is a fascinating evolution for sure. It confirms the maxim
that there’s often more to the story than meets the eye. There are
often roots to behaviors that go way back to past interests and
activities.
Given
your status and experience in doing this media work you undoubtedly
have some tips gathered over the years from what you’ve really learned
about doing this kind of “performance teaching”.
Schaffner:
I know in later years after I started that organizations have
introduced media training for their professional staff or faculty and
I've had just a touch of it here and there. Some very simple lessons
--- one of them is of course you can find out what the interest of the
journalist is, and what's the story all about. You may have the
opportunity to work with your own public relations office since those
folks are very helpful to you. And whatever the subject is, take a
deep breath, sit down for a moment, and think of what your SOCO is,
i.e., your single overriding communications objective. Focus on just
two or three..
And then
as you do this interview, no matter what question you’re asked, you
can always bridge to your SOCO. You can say “what I would like to
emphasize” and then keep going back to your SOCO. Of course it’s very
important to keep everything that you say based on the best and latest
public health science.
The
other lesson is just keep it simple; don’t get complicated. Always
figure out what does this mean to the average person. You can pitch
your messages so that they are understood by your proverbial
grandmother or relative who has a high school education. That is the
level at which you want to pitch your messages.
This may not be for
everyone, but I think a lot of people could become effective
communicators when they find themselves in a position in academia or
in public health communicating with a larger audience.
EpiMonitor:
What do
you think are some of the personality traits that make some people
more effective at this? I mean you've alluded to the fact that for
you it's kind of fun just like it was fun to participate in theater.
I think many people would look at it as the opposite of fun. But again
what more would you say about personality traits?
Schaffner:
I don't have any hidden agendas and I try to be objective. We public
health professionals are still looked to with a certain respect, and I
think we can take advantage of that as we communicate. I think of
myself as an ambassador representing the best public health practice,
and explaining infectious disease issues to the general public.
Part of
my concept is realizing that journalists are in the business of
communicating and that they need the story. And if we have important
information, we need to communicate that information. We need them
because they are our means of communicating with the general public.
We need to be able to get on the TV news and have access to print
media in order to communicate in rapid fashion to the general public.
So I
have always seen journalists as partners, not adversaries and I try to
convey that when I'm communicating with the journalists. You often
have an opportunity to chat before you start the interviews and I try
to establish a personal relationship with the journalist over time.
When you see them the second and third time you can ask “how are you
today”? I try to develop a personal relationship with each one.
EpiMonitor:
I think the more we talk the
more it's obvious that it is not accidental that you have come to play
the role that you play, that you have really mastered some aspects of
it. I think there is a recognition that you're good at what you are
doing because they seem to come back to you time and time again for
help with one problem or another.
Schaffner:
I try to make my interviews a little conversational and occasionally
with a touch of humor. That's not for everyone but you are allowed to
smile when you do that and I think people respond to you a little bit
better. I think that helps you to be comfortable in the environment.
Others prefer always to be a little bit more serious. That depends on
your personality.
EpiMonitor:
Changing the subject a little bit, how has COVID-19 been most
different, if it has, from other topics that over the years you've
been asked to talk about? I know that many epidemiologists have come
out of the woodwork in the last year because anybody who has anything
close to those kind of credentials has been consulted or asked to
speak because the topic has been so much in the news and so important.
Have you considered COVID-19 just more of the same in terms of its
challenges to you as a speaker or do you think the situation has
presented special challenges in communicating?
Schaffner:
The
information about COVID that is desired by the public and by the media
is unlike anything I remember in the past with any other outbreak. The
Director of our news
office
once told me to remember “this is a marathon not a sprint”. Later I
told him, with COVID, we’re all “sprinting a marathon”.
The
other item which is really quite important to recognize is that public
health policy overlaps with politics. That's been more evident with
COVID than
with
anything that I can remember. It is very delicate. In Washington not
so many months ago you would have national public health authorities
saying one thing and literally within minutes, political leadership
saying something quite different.
I've had
a personal goal of avoiding politics directly and more specifically
avoiding two words—“President” and “Trump”. I stay with the science
and make nothing personal. On occasion I will actually feel a need to
say this is not a political comment I'm about to make but a public
health matter.
I have a
personal goal or approach where local journalists always come first.
I will try to make time for reporters from the local newspaper and
from local TV stations and even weekly local newspapers. That's
because I'm a representative of my medical center and am identified
with local public health issues, so I go out of my way to be
accommodating when requests come in.
EpiMonitor:
As a frequently consulted person, what fraction of your total
“performance teaching”, if I can keep using that term, do you think
happens locally and how much of it happens with national or regional
media?
Schaffner:
About
half and half.
EpiMonitor:
How have you managed to stay on top of the COVID-19 situation because
the amount of new information and the number of new papers being
published is happening at an unprecedented pace?
Schaffner:
For sure, all this new information is something that we're all trying
to keep up with. Covid has really entered and taken over our lives in
a very substantial way. I'm involved in a lot of teaching here at the
medical center for learners at all levels. I’m also the medical
director of the National Foundation for Infectious Diseases which is
devoted to providing information for the entire spectrum of medical
professionals as well as the general public. I continue to collaborate
with colleagues at the CDC. All these activities help to keep me
current.
EpiMonitor:
In a way you're in a good position because the daily demands of the
jobs you have do force you to stay in touch so then you can be in
touch when you talk to journalists. Not everyone has jobs like that. I
suspect that a lot of epidemiologists have had their jobs taken over
or their daily preoccupations taken over by COVID-19. In that sense
whether they wanted to or not perhaps they have had to stay in touch
because their job changed or their focus changed as a result of COVID.
Still, there is a lot to keep up to date on. How can scientists not
lose the confidence of the public when they change their guidance on a
topic?
Schaffner:
This is one of the most difficult challenges for all of us whether we
are journalists or we are people who are trying to teach through the
media. We need to keep reminding
people that what we're saying today will be changed next week as we
acquire new information.
EpiMonitor:
I want to ask you about what I call science hesitancy. Sometimes there
is a need for speaking with a certain amount of confidence about what
you're saying because presumably people are getting guidance from you
whether it is about wearing masks or how far you have to stay away
from other people or whether you can get COVID from surfaces.
Scientists by the nature of what they do have skepticism as part of
their mindset. They are not really well equipped or well-qualified to
speak confidently or without hesitation and without caveats.
You
could say there are professional handicaps for scientists as
communicators because nobody wants to hear from someone who doesn't
have confidence in what he or she is saying. How do you react to that?
Do you feel that science hesitancy has sometimes been a problem?
Schaffner:
That's your most trenchant question. Scientists have to re-learn if
they're dealing with the media. We like to learn more and more about
less and less. But when you communicate with the general public,
you’ve only got 30 seconds. You have to paint with a broad brush. You
look to role models. Tony Fauci is a genius at this, that is,
shaping what he says in order to communicate effectively with the
general public. .
Public
communication is not for everyone. Some are better at it than others.
Not everybody in baseball can be a third baseman or a shortstop. There
are multiple individual ways to play and we can't expect everyone to
be a utility infielder who can play a whole variety of different
positions.
EpiMonitor:
That's
very interesting and I think there is that element of people having to
relearn because I think each occupation has its frameworks and its own
worldviews and those come into play in dealing with the media. They
are part of your training and part of the way you think and so if you
have to relearn that can be difficult.
One of
the things I have been aware of during my career is that public health
epidemiologists have a particular learning challenge because they are
both scientists and public health people and I think they have
different goals, different purposes in the end. I could venture to say
for scientists it's primarily about getting to the truth, and for
public health people it’s about the well-being of a population.
Sometimes you are willing to recommend or give guidance to take action
when the amount of information you have is less than you would like to
have. The amount of certainty you have is not optimal, but there's
enough there so that in your opinion the prudent course of action is
to recommend that people act or take action even though the data may
not fully support it.
So I
think public health epidemiologists wear two hats and have to not only
relearn but in a sense switch hats from time to time. This has to be
more challenging then if you're a physicist or a geologist or some
other scientist in a field where there isn't this “two hat”
implementation or applicability challenge that goes along with the
science. What's your reaction to that?
Schaffner:
I could not agree more. One way I talk about this challenge is using a
metaphor. Think of having a house being built on a rock solid
foundation of science. Based on that foundation, you can build a
house that's designed by a modern architect or you can design a house
that's reminiscent of a turn of the century Victorian house.. Likewise
you could have different public policies based on the same science and
that's particularly true when the science is very limited. You’re
going to have to justify based on the science but then you're going to
have to explain how that science is going to be applied in a public
health context. You have a certain amount of information and you try
to apply it and you have to explain how the science justifies the
particular architecture of the house of public policy on top of that
foundation.
EpiMonitor:
I love that metaphor because I came to learn in my career in dealing
with autism and vaccines that the facts don't speak for themselves.
The foundation may be there but the foundation is not the house. There
has to be something else on top of the foundation and I came to learn
about the importance of the values that come into the decision making.
One of
my conclusions is that it's really not all about evidence-based
decision-making but rather it is about evidence-based and
values-oriented decision making. The architecture that you were
talking about is based on and created out of our values and we don't
often admit that when we talk about evidence. Those values are more
difficult to talk about.
Schaffner:
I surely do think that our values influence our public policy. Let me
give you a COVID example.
I think
one of the characteristics of our public communication about COVID has
been that we have not ranked the economic and personal consequences as
highly as the public health. We have not recognized that these are
also imperative. In order to make public policy you are like a
tightrope walker with a pole. The public health issues are at one end
of the pole with the economic, social, and cultural issues at the
other end.. The governor, or mayor, or president are all trying to
balance these values to get through to the other side of the pandemic.
I don't think we in public health have sufficiently recognized good
public policy has more items in it than simply flattening the curve.
We have to recognize that there are also other values that are
important to the continuing optimal functioning of our society. The
trick is to keep them in balance.
EpiMonitor:
Well as someone who's thought a lot about the connection between
science and values in policy making, I do really appreciate your
metaphor. It is difficult to discuss and navigate conflicting values.
Schaffner:
I think conflict has become more stubbornly entrenched. It is more
difficult for us to speak with each other. We recognize that we come
to an issue with different values. Many people are harder for us to
understand whatever the issue is because we don't speak with each
other. I take my hat off to my wife because she periodically listens
to different news sources to find out what they're saying and what the
thought process is. In her own way she's trying to reach out and
understand people who have a different political philosophy than we
have in our house.
EpiMonitor:
I know that we have had different stages in this pandemic and things
have not always been the same, but let me just throw it out there. Do
you have an opinion on our overall public communication during COVID.
What grade would give public communication at this point?
Schaffner:
I think
clear, science-based, honest, and sustained communication to the
general public should be the goal at the very top of the list. In the
United States the highest level of communication often led to
confusion and uncertainty and a loss of confidence. That’s changed
over time and I think we are restoring good science-based public
health communication.
EpiMonitor:
Thank you Bill for sharing your valuable insights about public
communication of science related topics. You have set a high bar for
all good communicators to aspire to and we are all in that situation
of speaking to a large audience during our careers at one time or
another.
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