Heidi Tworek is Associate Professor of History and Public Policy at the University of British Columbia. Ian Beacock is a journalist and strategist. He was most recently a postdoctoral fellow in the School of Public Policy and Global Affairs at the University of British Columbia.
Perhaps you heard about Alberta’s creepy “Mr. Covidhead” advertising campaign, rolled out to much fanfare in early December. Unless you were paying close attention, however, you might have missed the clever messaging work done by Sukhmeet Sachal and his Sikh Gurdwara Initiative in Surrey, B.C., making public health guidance more accessible to Punjabi-speaking communities in British Columbia’s hard-hit Lower Mainland. Or the efforts of volunteers in Ontario’s Peel Region, through the grassroots South Asian COVID-19 Task Force, to offer better, clearer and more culturally sensitive health updates to diverse populations. These are innovative COVID-19 messaging strategies worth celebrating.
What’s striking, however, is how few of these communications breakthroughs there have been — and how many of them have been led not by government, but by members of civil society moving to address key messaging failures.
Last spring, communications were rightly identified by Canadian authorities as a critical part of the COVID-19 response, what epidemiologists call a non-pharmaceutical intervention (NPI). Politicians promised multimillion-dollar advertising campaigns, and officials like Prime Minister Justin Trudeau and B.C.’s Dr. Bonnie Henry earned plaudits for their in-person updates.
Lately, however, this energy has dramatically dimmed. Press briefings remain a powerful tool, but politicians and health officials have been leaning too heavily on them to connect personally with the public. And they’re no longer “must-watch” television as they were in the first weeks of COVID-19. Several recent public health campaigns have simply featured the same authorities speaking directly to camera, and it’s hard not to wonder if Canadians are tuning out. Rising case counts and mounting fatigue have led to the feeling that things are inevitably going to get worse. Health messaging is now more minimal, pleading with people to hang on and stay home until the vaccine arrives, although many workers cannot do so. Proactively building trust and shaping habits no longer seem to be priorities. Today, only 35 per cent of Canadians have faith in the ability of their fellow citizens to flatten the COVID curve.
Rebooting our messaging for 2021
Across Canada, communications helped to right the ship during the initial few months of COVID-19. The same was true worldwide: we studied the first-wave messaging strategies of nine democracies on five continents, from Senegal to South Korea, and found that effective communications were integral to the finest pandemic responses.
Smart messaging can help again — and it’s more important than ever now that everyone is running on fumes. Compared with NPIs like testing and protective equipment, thoughtful communications are relatively cheap to implement. And by looking at other countries that have communicated well (and creatively) throughout COVID-19, we can expand Canada’s pandemic messaging toolbox. But there are two critical facts that Canadian policy-makers should understand as they reboot their pandemic communications for 2021.
The first fact, obvious in case numbers and mounting public alarm but less evident in the messaging strategies used by governments, is that we’re in a new phase of this pandemic. Although each province experienced early COVID in its own way (Quebec was especially hard-hit, Manitoba recorded virtually no cases before the fall, etc.), the communications challenge of the first wave was straightforward: instill a feeling of urgency, tell citizens to stay home, repeat basic hygiene measures without exceptions. In Canada, this broadly worked. Citizens steeply reduced their social interactions.
Perhaps the most crucial principle for Canadian officials to keep in mind is that the public is not monolithic: populations are diverse and their needs change over time. It’s therefore crucial for health messaging to meet people where they’re at.
Nearly one year later, as we wait for vaccines, our situation is more complex and the work of communicating public health information has become more difficult. The more we’ve learned about COVID-19, the more targeted provincial measures have become. B.C. in particular has found ways to keep most bars and restaurants open. We know now that physically distanced outdoor activities are safe, that the virus doesn’t spread via surfaces like playground equipment or subway seats. The result, however, is that most Canadians are now navigating a sprawling list of activities that are permitted and others that aren’t. And as our unknown emergency has become a tiring new normal, fear-based messaging has lost its power to shock.
In this more complicated new phase, Canadian public health communications need to do three things at once. Messaging needs to support the ongoing project of habit-formation, helping Canadians to internalize new pandemic norms and behaviours. It also needs to lay the groundwork for vaccine uptake by building confidence, overcoming skepticism and swiftly countering misinformation. Finally, messaging also needs to concern itself with habit-retention, making sure that exhausted Canadians don’t abandon hygiene practices now that the pandemic’s end is in sight.
This is a tall and daunting order. But the second and much more optimistic realization for Canadian policy-makers is this: the strongest strategies and best messaging practices from the first wave are still effective. As we found in our research, thoughtful communications lie at the heart of many of the world’s most effective COVID-19 responses, in democracies from New Zealand to Senegal. What can we learn from them as we enter 2021?
Meeting people where they’re at
Perhaps the most crucial principle for Canadian officials to keep in mind is that the public is not monolithic: populations are diverse and their needs change over time. It’s therefore crucial for health messaging to meet people where they’re at. This means acknowledging that citizens are no longer anxiously seeking out public health information themselves, as they did last spring. It also means going beyond press briefings and video advertisements to find people where they live and speak with them there. This might involve the use of WhatsApp channels and chatbots (as Germany and Senegal have done), making creative and playful cartoon memes for online message boards (Taiwan), or enlisting members of the public to advise on social media strategy (South Korea). Certainly it means translating health guidelines into widely spoken languages like Mandarin, Cantonese and Punjabi — and then investing in communicators who can bring those technical factsheets to life by appearing on local multilingual media and meeting with people in their communities. Not doing so will exacerbate pre-existing inequalities and racialized health disparities.
As we suggested at the beginning of this essay, the most creative Canadian efforts on this score have been undertaken not by public health officials but by ordinary citizens: people like Toronto-based surgery resident Dr. Amanpreet Brar, who has taken it upon herself to share COVID guidance with Punjabi-speaking radio and television audiences. Government officials should be formally supporting these initiatives and fully integrating members of civil society into their messaging strategies. This is what Senegal did last summer, when government social media channels posted videos of religious leaders washing their hands and practicing good COVID hygiene. Involving imams and Christian leaders from the start helped mitigate the backlash generated by the closure of mosques and churches.
Jacinda Ardern, the New Zealand premier with a communications degree, hosted a video podcast called “Conversations through COVID-19” last spring. Interviewing a diverse set of guests from business leaders and parents to Indigenous scholars, Ardern was able to elevate and more effectively communicate with specific communities. Making space for civil society within official pandemic communications expands the capacity of government messaging and allows authorities to reach more deeply into vulnerable communities. But it critically builds trust in those communities, too, a key ingredient for public health compliance and vaccine uptake.
The behaviour of politicians and health officials also sends a message. Researchers in the U.K. found last summer that British confidence in public health guidelines sharply dipped after Dominic Cummings, a top advisor to Prime Minister Boris Johnson, violated COVID lockdown rules without consequence. Too many Canadian authorities, from politicians to health executives, have broken the rules they implored other citizens to follow, especially during the Christmas holidays. To clearly communicate the solidarity required for public health, elite rule-breaking must have severe and transparent consequences.
It’s also true that Canadian public health communications and the civil servants who lead them are painfully under-resourced. Greater institutional capacity would have allowed our governments to more easily and swiftly implement these strategies. This is the lesson that Taiwan and South Korea learned after previous disease outbreaks (SARS in 2003; MERS in 2015). Both jurisdictions built permanent offices for pandemic communication, giving them the ability to produce a deluge of innovative public health content during COVID-19. Institutionalizing and properly funding public health communications in Canada will help equip us for the next pandemic.
It has been enormously frustrating to write this essay so many months into this pandemic. We know that a range of jurisdictions, from South Korea and Taiwan to Senegal and New Zealand, have executed highly impressive and relentlessly creative messaging strategies to respond to COVID-19. There is no reason why Canada can’t adopt similar ideas to smooth the path forward to mass vaccination and save lives. But for that to happen, officials must remember to take communications as seriously now as they did last March. Briefings and bromides just won’t cut it.