Like most crises, the COVID-19 pandemic requires three kinds of risk communication.
- Before the crisis, the task is “precaution advocacy” – warning a complacent public. The U.S. pretty much failed at that one.
- During the crisis, the task is “crisis communication” – guiding a frightened public. As the report Jody and I are writing for CIDRAP points out, the U.S. isn’t doing such a great job of that one either.
- After the crisis or between waves of the crisis, the task is “outrage management” – addressing recriminations about what went wrong. That’s the one that’s on deck right now, as officials face outraged criticism from all sides, much of it justified.
As I said in an earlier email, that’s the normal natural history of a crisis: precaution advocacy, then crisis communication, then outrage management. Mid-crisis, people are mostly frightened and miserable; they’re upset about the situation, and reluctant to launch aggressive attacks on the people they’re counting on to protect them.
When recriminations start to become paramount – as is happening right now vis-à-vis COVID-19 – that’s a watershed, signaling that we’re entering a “post-crisis” period. In the case of COVID-19, however, it’s almost certainly a temporary “post-crisis” period; we’ll be back in crisis mode if/when a significant increase in infections yields a lot of deaths, or overwhelmed hospitals, or a return to lockdown (or worse, an unsuccessful effort by authorities to return to lockdown).
I think three competing (even diametrically opposed) sets of claims are all valid bases for outrage:
- The under-reaction claim: In parts of the country, the response to COVID-19 was delayed and weak. Officials unwisely prioritized “allaying panic” instead of allaying the spread of the virus. Lockdown then became necessary, not because it was inevitable but because our leaders had screwed up. And now we’re very worried about coming out of lockdown prematurely or chaotically, mishandling the next phase of the pandemic as badly as we handled the first phase. (Some of this grievance is grounded in misleading frames – especially people’s sense that we ought to be able to come out of lockdown without a lot more illness. But much of it is simply valid.)
- The over-reaction claim: In parts of the country, the response to COVID-19 was excessive – as if the big cities on the two coasts were the whole country and flyover America didn’t need or didn’t deserve a separate set of policies. There are countless rural counties with zero confirmed cases. There are countless hospitals so empty that healthcare workers have been furloughed. Much of the U.S. public health profession assumes and even asserts without building an evidence-based case that these places, too, needed to be locked down and now need to reopen carefully, cautiously, slowly, and not until they have lots of testing and contact tracing capacity. How dare they destroy our economy (too) just because of their mishandled outbreak!
- The biased response claim: Once again the powers-that-be have done more to protect other people’s health than to protect my health. (This is a claim that can be made with considerable truth by healthcare workers; “essential” workers in low-income, high-touch occupations; residents of nursing homes; African-Americans; and others.) And once again the powers-that-be have done more to protect other people’s economic welfare than to protect my economic welfare. (This is a claim that can be made with considerable truth by many of the same groups, as well as some others: renters who risk eviction; the retired whose savings are threatened; etc.) Despite all the rhetoric about how “we’re all in this together,” both health policy and economic policy are zero-sum games; COVID-19 has not ameliorated that, but rather has made it more vivid than ever. Specific low-power groups have borne the brunt of both the pandemic’s health damage and the lockdown’s economic damage.
So the powers-that-be are beginning to face explosions of outrage from all sides on an inexhaustible list of issues. Off the top of my head:
- Why didn’t you warn us sooner and more fervently?
- Why didn’t you prepare better – e.g. PPE?
- Why didn’t you manage better – e.g. testing rollout?
- Why did you underreact in my community?
- Why did you overreact in my community?
- Why didn’t you implement lockdown sooner?
- Why didn’t you stay locked down longer?
- Why didn’t you let us come out of lockdown sooner?
- Why did you implement lockdown at all?
- Why did you underreact vis-à-vis New York City, other big cities, nursing homes, other congregate settings, etc.?
- Why haven’t you protected healthcare workers, grocery store workers, meatpacking workers, etc.?
- Why is so much economic aid going to big business and people who don’t need it, while ordinary folks can’t pay their rent (and it isn’t forgiven), etc.?
- Why is COVID-19 yet again discriminating against African-Americans?
- Why is ageism being tolerated, as if elderly lives were hardly worth saving, especially in nursing homes?
- Why is so much being sacrificed to protect elderly people with very few quality-of-life years left anyway?
As always, COVID-19 outrage will tap into preexisting grievances and ideologies. It won’t just be about COVID-19 policies. It will be about freedom; about equality; about too much / too little government; about the arrogance of egghead experts; about left versus right; about globalism versus nationalism versus federalism; and endlessly, pointlessly about Donald Trump.
The outrage management challenges of the coming weeks and months will make infection-related precaution advocacy infinitely more difficult. It is very, very hard to warn people to abide by social distancing measures and the rest when they’re so outraged at you that they want to kill, and trust absolutely nothing you say.
It follows that a second COVID-19 wave is likelier – and will be more devastating – because outraged publics will be unresponsive to pre-crisis warnings emanating from the authorities at whom they are outraged.
And most public health experts and government officials – the two groups that are going to need outrage management skill the most – have very little training or experience at ameliorating stakeholder outrage. Experts prefer to lecture outraged people rather than listen to them. Politicians prefer to cater to supporters rather address the grievances of opponents. Below are the six main strategies 
of outrage management. Imagine public health experts and government officials even accepting that these six are what they should be doing … much less doing them well.
- Acknowledge prior misbehavior (including errors).
- Acknowledge current problems (what’s genuinely going wrong).
- Stake out the middle (validate opponents’ valid claims instead of rebutting their invalid ones).
- Share control and be accountable.
- Discuss achievements with humility (give credit to opponents for improvements).
- Pay attention to unvoiced concerns and underlying motives.
Copyright © 2020 by Peter M. Sandman
