CMU expert: In times of crisis, people want facts, not spin
With no cases yet of COVID-19 in southwestern Pennsylvania, the sense of fear that has gripped places like Kings County, Wash., where, as of Thursday, 10 people had died, has yet to engulf the Pittsburgh region.
“We’ve gotten about 20 calls a day,” said Kathleen Rosatti, director of infection control for Excela Health, which has three hospitals in Westmoreland County.
“Some people are asking about symptoms,” she said, with all the cases ruled out for any testing for COVID-19. “But moreso they’re asking about travel. Can I go on that cruise? Can I get on that plane?”
Ms. Rosatti’s infection prevention staff has yet to describe any of these interactions as “fear,” she said. “I’m going to say that through the efforts to inform the public, that helps lessen that possible panic level.”
True panics — outside of movies anyway — thankfully are rare.
“Feeling panicky is one thing,” said Baruch Fischhoff, a professor of public policy at Carnegie Mellon University and an expert in how people make decisions in crisis. “But a second [form] is a mass panic, where people are sort of, ‘Every person for themselves,’ they’re abandoning their social roles. And that’s extremely rare.”
Research on crisis events like 9/ 11 and others show that people tend to behave more responsibly than public officials themselves believe they will.
“There are probably more panics in the movies than there are in real life,” said Mr. Fischhoff, who holds a doctorate in psychology and is currently writing a book on decision making.
Sounding not unlike another notable Pittsburgher — Fred Rogers and his famous “Look for the helpers” quote about times of crisis — Mr. Fischoff noted: “It’s important for people to realize that in emergency situations that people band together, they help one another.”
That may be the response once an event like 9/11 truly becomes an unmistakable crisis. But how do people make decisions on what to do in the buildup to a potential healthcare crisis like, say, Ebola, which Mr. Fischhoff has researched?
How do they make decisions on whether to travel? Or when to finally contact a doctor if they are feeling sick?
“In risk analysis,” he said, research shows “there are three elements people go through.”
First, people assess themselves and ask: What is the background risk?
People try to learn about a
situation, and, currently with relatively few confirmed cases nationally compared to the thousands in China, that probably affects most people’s decision, he said.
The second is that people ask themselves: How do I feel now?
“’And if I feel sick, how do I tell if it’s coronavirus that’s causing it?’” he said. “It’s hard to tell if you have coronavirus or seasonal flu.”
The third is, if I’m concerned about this, what should be the threshold for, say, calling a doctor?
“In any population you’ll have people who have different thresholds. Some will just [go to see a doctor] because they feel sick. Others because they’re vulnerable because maybe they’re immunocompromised, or they’re stressed because they’re watching too much alarmist TV or too many Twitter feeds, or because they’ve been through something previously.”
So if someone is debating whether to go on a cruise they bought tickets for, they might even tell themselves that they’ve done the research and the cruise line is known for good hygiene, he said.
“But then you have to ask yourself, ‘Am I going to be worrying about this all the time?’”
And that’s where more effective communication from government leaders on this would be helpful, he said.
“If the people who are responsible for this are doing their jobs, then they should not be aggravating our fears, or trying to chill us out,” Mr. Fischhoff said. “They should just be giving us the facts so they’re not biasing one way or the other. And they should put us in a position where we trust them so we’re not feeling we were duped into doing something that’s not right. If you feel like you were duped, that’s also a source of stress.”
Wading through
In his 2017 study about how 3,400 Americans felt following the 2014 Ebola crisis, Mr. Fischhoff and colleagues from the University of California-Irvine found that despite confusing communication from public officials early on, people pretty effectively did, in the end, manage to wade through and figure out what was going on and what the risks were to them.
“In general, respondents supported providing ‘honest, accurate information, even if that information worried people,’” Mr. Fischhoff and his colleagues wrote in the study.
It’s something Mr. Fischhoff said has not been the case from national officials in the COVID-19 outbreak.
“In terms of communication I don’t think our system has learned very much,” he said.
Even though the federal Centers from Disease Control and Prevention has tried to communicate all it has so far and quickly, “you’re still reading that our hospitals [in affected areas] are under a lot of stress, and the time they have to prepare and train people and to have resources for dealing with this contingencies, they’re really stressed.”
Nationally, he said, “I think the official communications have been routinely poor. As much as I love the CDC, they’ve never to my mind taken behavioral science very seriously” which might help them craft better messages in times of crisis, he said. “They don’t test their messages before they’re released. And they don’t test them with diverse audiences.”
Political leaders have not helped, he said, because they “are often terrible communicators in places where the facts matter. Because they’re accustomed to leading by symbolic manipulation, things that they can spin. And you can’t spin these facts if something gets out, or people are getting sick.”
There have been two big counterbalances to that during the COVID-19 outbreak, he said.
Locally, he said, different agencies from the Allegheny County Health Department — which has provided updated recommendations including recommending people not shake hands — to the Diocese of Pittsburgh — which banned serving wine from a common cup at services or hugging or shaking hands during the sign of peace — have been “internalizing the message.”
“I think each organization translating it into what it means for action in their arena, and what it means for their particular audience, is building a sense of social solidarity,” Mr. Fischhoff said. “That we’re in this together and we’re going to help one another.”