Trust in H1N1: Uncertainty

Earlier this year, the scholarly journal Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Research published an extremely interesting article entitled Exploring communication, trust in government, and vaccination intention later in the 2009 H1N1 pandemic: results of a national survey. If you know someone who has access to that journal, I highly recommend you read the article. And if you don’t know someone, I’ve pulled out three of the biggest points from the article, and plan to talk about it all week in a series I’m calling Trust in H1N1. You can find links to the other two posts on this article following today’s post.

Today we’re talking about uncertainty.

Uncertainty is a strange thing. In emergencies, like a pandemic, the only thing that you can be completely sure of, is that things will change. The situation, the recommendations, the guidance, the response, the players. Some, or all, of it will change. Change breeds uncertainty. Uncertainty about a situation leads to doubt, unfocused response, questions and recriminations. Uncertainty is a capital “B” Bad Thing.

But if it’s a constant in emergencies, why is it so bad? Well, it’s bad for the response for obvious reasons. When you don’t know what’s going to happen next, it’s tough to plan, but there is another reason, and it has to do with trust.

Many response communicators worry that if you keep changing the message, you’ll ruin your credibility. And that’s not completely untrue. A communicator that constantly changes their message will appear scattershot, unfocused and unbelievable. But in an emergency, by the very nature of the emergency, things will change and what we’re saying will have to change. So what do we do?

The article we’ve been reviewing deals with this idea of uncertainty and trust, quoting no less than former CDC Director Dr. Richard Besser during the H1N1 response:

I want to acknowledge the importance of uncertainty. At the early stages of an outbreak, there’s much uncertainty, and probably more than everyone would like. … We’re moving quickly to learn as much as possible and working with many local, state and international partners to do so. … I want to acknowledge change. Our recommendations, advice, approaches will likely change as we learn more about the virus and we learn more about its transmission.

The research showed that the openness shown by government officials was greatly appreciated by the public.

By addressing uncertainty early in the crisis, it appears the government was able to influence the public’s acceptance of future changes in understanding and behavioral recommendations. In our results, we saw over 90% agreement with the item, “I understand that information about swine flu will change as scientists learn more about the virus.”

The problem isn’t that we have to change our messages. The problem is that we aren’t being honest with our publics. We still think we can get in front of them, tell them what’s what and that we’re in charge. We’re not being open and honest and letting them know that, hey, we’re not positive, we’re not perfect, but dammit, we’re working hard and we’ll keep you in the loop because you’re important and vital and we want you on our team.

That’s what Dr. Besser was talking about. Openness, honesty, transparency. These aren’t just hallmarks of a twenty-first century communications system, they are vital parts to mounting an effective emergency communications campaign. They are vital to success. As we’ve said before, a poorly executed information campaign can sink any response. Not being trusted, not being believed is item 1A in the definition of a failed response. Not dealing with uncertainty early is one of the best ways to destroy that trust.

Trust in H1N1: The Messenger
Trust in H1N1: Building Trust