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Health communication expert gives U.S. a “C” for pandemic performance

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COVID warning placards near the Navajo nation town of Tuba City, Arizona.

Warning sign: To end the confusion about pandemic information, said Cynthia Baur, officials need to "get back to the communication basics, which are to explain things very clearly and simply in a jargon-free way." Mark Ralston/Getty Images

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As the United States reports record levels of new COVID-19 cases, the health communications industry is facing greater stress. Recently, the Centers for Disease Control and Prevention has faced criticism for its communication about the pandemic, including the decision to shorten the isolation period for people who test positive for the coronavirus.

“Marketplace” host Kai Ryssdal spoke with Cynthia Baur about the health literacy and health communication practices we’ve seen during the pandemic. Baur is director of the Horowitz Center for Health Literacy at the University of Maryland School of Public Health, and earlier worked at the CDC for 10 years. The following is an edited transcript of their conversation.

Kai Ryssdal: Is health literacy usually this hard? It just seems to me we’ve been going around and around.

Cynthia Baur: Actually, it is pretty hard because human communication is pretty hard. There’s a lot of misunderstanding and confusion that goes on, and COVID has just kind of been Exhibit A of how hard it is.

Ryssdal: Well, I was just gonna say you throw in a pandemic, and everybody’s sort of awareness and agita goes up a factor of 10. Is there an easy way out of the communications mess that we find ourselves in now with public health, do you think?

Baur: There’s not an easy way, but there is a way out. And part of that is to kind of get back to the communication basics, which are to explain things very clearly and simply in a jargon-free way. And to do it as frequently as possible.

Ryssdal: I wonder, though, if that’s part of the problem, right? Because health literacy and health communication is not standard brand communication, right? Advertising is you got to hit people with it a zillion times. And now it seems to me that there’s almost too much information, some of it conflicting, that is making the, the health-communications-consuming public a little bit weary.

Baur: Well, that’s a really interesting point because there is a lot of information out there. But there’s a lot of information that is either intentionally, or maybe unintentionally, kind of confusing the information environment. So for example, there are a lot of people who’ve decided they want to try and interpret what the federal agencies like CDC and [the Food and Drug Administration] are saying, and in many ways that is muddying the waters as much as being helpful.

Ryssdal: Yeah. You were at the CDC for many years. And I just wonder, based on your experience and your insights, do you imagine that the communications professionals there, because government agencies have communications professionals just like brands and companies do, do you imagine they’re pulling their hair out?

Baur: I imagine they’re pretty tired. And I imagine they’re pretty frustrated that things haven’t gone better. I know they’re very dedicated, and they’re really trying to do their best. But this is a pretty complicated situation. And, you know, unfortunately, some of the early communication about the virus really sort of set things off on a pretty difficult path. So they’ve got a lot, a lot of ground to cover and make up for.

Ryssdal: Give me your perspective as a communications professional and as a woman who’s done health literacy communications for her life. When you look at what the CDC and others have been doing, what happens on the inside? How does that message get out and then get garbled?

Baur: Well, it’s a pretty complicated process. There are people with the designated role of being a health communicator or a health educator. And they work in teams, right? So they work with other subject matter experts about whatever the issue is, in this case, COVID. In the best case, they work on drafting that information together, but it still has to go up a chain through a clearance process. And you know, CDC might not be the only agency that’s involved in creating it. Other federal agencies might weigh in, external partners, for example, state health departments. So it’s a pretty complicated, multistep process. And in a way, we really do want our federal agencies kind of thinking about all these different factors before they put out information that could change, not just public policies, but also people’s individual behaviors.

Ryssdal: On the theory that you’re going to get invited to participate in whatever the post-mortem is for health communication during this pandemic, give me a letter grade. How are we doing so far?

Baur: Um, I would say a “C.” I think we haven’t completely failed it. I mean, there’s a lot of research that shows that people have learned some things about infectious disease and what public health does and sort of how to protect themselves. But unfortunately, we’re really far from where we could have been if the communication had worked, you know, like it should have from the beginning. So I would say it’s not a total failure yet, but I think we could have done so much better along the way.

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