Governments around the world have struggled with effectively communicating the public risks of covid-19. In the United States, polls find a public divided, largely by party, about which authorities they trust for information. The president and some other officials have been arguing that the economic risks of keeping everyone isolated are the biggest threats to the country and that businesses must reopen as soon as possible. Other officials argue that public confidence will only be rebuilt with expert scientific assessment that the threat is contained.
Whatever the decision, my research suggests that reopening will be difficult. Much of the public will not tolerate any level of risk — and will not trust experts or officials who tell them that it’s safe to go out again.
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During 2011-2014, epidemiologist Mark Korbitz and I conducted a study investigating public responses to risk communications in a fictional bioterrorist attack in Pueblo, Colo. Our goal was to find out what the public and officials would consider acceptable levels under different scenarios of biological threat.
The experiment, sponsored by the U.S. Environmental Protection Agency, involved approximately 50 Colorado federal, state and local elected and emergency response officials and 150 ordinary Coloradans. The Pueblo City-County Health Department sent these volunteers simulated newspaper articles about the fictional attack and recovery every two weeks for six months. The scenario depicted four people dying from the bioterrorist attack, and the destruction of more than 1.5 million livestock because disease spread to more than 2,000 animals nationwide, devastating the American ranching industry.
Participants responded by email or social media post, telling us their reactions to the information and what they would do if it were really happening. We coded their written responses, and transcripts of follow-up discussions, using the ATLAS.ti qualitative data program and cross-tabulated the categories of response with demographic data.
Participants were told that someone had released lethal anthrax spores into the local water supply and had seeded the animal virus called foot-and-mouth disease at the state fairgrounds. Humans couldn’t transmit these biological agents, unlike covid-19. Still, the study participants responded much as Americans have in 2020, which tell us something about what to expect in the future.
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‘I don’t trust the government’
A minority refused to believe official confirmations of the outbreaks by public health agencies, and some reported that they would ignore inconvenient rules. Most participants, including some government personnel, said they would not trust “the government” to tell them the truth about what was risky. Some questioned the expertise of scientific recommendations, writing, “Who would know that kind of stuff?”
Still, three months into the exercise, when presented with choices about which quarantine and decontamination approaches to support, virtually every participant opted to try to bring risk down to zero. The goal of the study was to determine public tolerance for acceptable risk. The experiment found that no risk levels were acceptable — even for participants who initially believed there was no risk.
In practice, this meant that both officials and the public demanded the most expensive and most disruptive decontamination procedures available, even when we informed them that the experts said these were unnecessary. Nearly half the experiment’s total responses involved our ordinary citizens telling us that no actions — not even the most extreme efforts — were enough to reassure them. One official told us that a 99.99 percent effective treatment for anthrax, which would have required shutting off the city’s water for one week, was unacceptable because “I don’t want to be the 0.01 percent who gets anthrax.”
Participants also resisted information that locations were now considered safe and were preparing to reopen. Study participants said they would never go back to places that had been hot spots, or would only go back after months in which no one else had died. They were particularly skeptical about proposed events to reopen public venues, an approach that the city of Toronto had used when it held a public concert after the city’s 2003 SARS coronavirus outbreak.
Our respondents often explained these positions by telling us that both politicians and businesses have economic reasons to try to convince them everything was safe again, and they feared that these would outweigh public safety interests. As one person put it, “I don’t trust the government in the first place . . . I won’t be like, hey they’re serving hot dogs out at the reservoir — let’s go!”
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Communicating after the covid-19 pandemic will be even harder
As the covid-19 threat stretches on, officials continue to debate whether to restrict economic activity, perhaps indefinitely. Some argue for rebuilding public confidence and reopening businesses as soon as possible, by extensively testing citizens. At the same time, governments and organizations have postponed major events like the Olympic Games and the Democratic National Convention until officials believe the risk from mass gatherings has become acceptable.
But the evidence indicates that most people will still stay away from “acceptable” minor levels of risk, no matter what experts and officials say. A recent YouGov-HuffPost poll found that 61 percent of Americans say they’d continue to stay home when possible even if their area lifted all coronavirus restrictions in mid-April. Although that survey was taken at a time when U.S. rates of infection were increasing exponentially, for many Americans, hearing that “it’s acceptably safe now” will never be good enough. The latest survey shows that just over one-third of Americans believe the public should be allowed to return to work “while the virus is still active,” even if that means social distancing indefinitely.
Yes, convincing the public to stay home has been difficult. But getting them to come back out may be a bigger challenge. Recovery is still distant, but officials may wish to start preparing now for how to persuade all Americans to trust that it is safe again.
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David Malet is an associate professor in the department of justice, law and criminology at the American University School of Public Affairs and the author of “Biotechnology and International Security” (Rowman & Littlefield Publishers, 2016).
The research described in this article has been funded wholly or in part by the EPA through Grant #83498701 to the Pueblo City-County Health Department. This article has not been subjected to the EPA’s required peer and policy review and therefore does not necessarily reflect the views of the EPA.
