COVID vaccine won’t be effective if people don’t trust leaders

This week has jolted the American public from its pandemic fatigue into something we haven’t felt much this year: hope.

Monday, In the space of just a few hours, Pfizer announced that its COVID-19 vaccine is more than 90 percent effective in late-stage clinical trials, the U.S. Food and Drug Administration granted emergency approval to Eli Lilly’s antibody treatment and President-elect Joe Biden unveiled his coronavirus task force to applause from public health experts. All that good news made it seem like the United States finally stood a chance at rounding that mythical corner.

But we’re not there yet.

The nation’s other epidemic — our blurred reality and the disinformation that feeds this confusion — remains robust. For example, as soon as news of Pfizer’s progress broke, anti-vaxxers peddled conspiracy theories and vowed to resist the vaccine. This reaction illustrates the larger problem overshadowing the U.S. coronavirus response, which is that our leaders in healthcare and government appear powerless against a great wall of health illiteracy. Even the brightest public health experts can do little to thwart the COVID-19 pandemic when they lack the public’s trust.

And faith in our institutions, scientists and leaders is slipping.

In October, the nonpartisan Kaiser Family Foundation released a poll revealing that only about 30 percent of Americans had a “great deal” of trust in the FDA and the U.S. Centers for Disease Control and Prevention. More than 60 percent of Americans are concerned the FDA will rush approval of a coronavirus vaccine. These findings followed a September poll that detected declining trust in the agencies and top health officials like Dr. Anthony Fauci.

We know the consequences of disbelief: fewer people wearing masks and social distancing, and more cases of COVID-19, hospitalizations and deaths. If the trend continues, we could soon add vaccine and drug resistance to that list, and the death toll might far exceed the 240,000 Americans already lost to the virus.

In other words, the steps forward this week might prove futile. But the country has a chance to rebuild public trust and health literacy to ensure a more effective coronavirus response.

Family doctors have a near monopoly on confidence when it comes to COVID-19 information. The Associated Press last month found that 53 percent of Americans trust their physician a great deal or quite a bit, while just 36 percent said the same of federal health agencies. Even before the pandemic struck, a private survey found that nine in 10 Americans considered physicians the most trustworthy of any professional.

It’s time for the United States to leverage the trust in everyday doctors — the one resource that remains far out of reach for the world’s most powerful government — to fight the pandemic. The doctors we turn to when our children and parents are sick must join coronavirus task forces. We must begin to see these physicians representing hospital systems and governments when we turn on the TV or scroll through social media. Those in power must tap the influence of those in the clinic.

President-elect Biden should fill out his well-credentialed coronavirus task force with community physicians who understand everyday people. The current makeup of the task force is exceptional, but there’s no indication that its members know how to drive home critical information to those outside the ivory tower, like the senior citizen’s club member, the soccer parent and the longhaul trucker. The local doctor does. The successful fight against COVID-19 requires leaders who speak their language, not unlike how President Trump did during his first campaign.

That same principle suggests that the nation needs a surgeon general who is of the people. Someone to whom TV audiences can relate, even when there’s no hyped-up hysteria and snake oil on the screen.

Health systems must apply these same principles to their patient-engagement efforts. Once upon a time, marketing and communications were cute ways to bring in more revenue. Now, they are integral to tamping down a ruthless pandemic, and our hospitals have a chance to use their resources to raise health literacy — and thus improve health.

This isn’t a one-physician-fitsall proposal. Different communities and populations need to hear from voices they’re more prone to trust. To help parse these details and set a broader strategy, we’d be wise to establish a medical communications task force — because our destructive echo chambers likely will outlive the coronavirus.

In the United States, everyone wants a fast-acting pill, whether it’s for diabetes or a global pandemic. But there is no simple solution for COVID-19. Preventing the spread of disease is about taking small, non-clinical steps, such as wearing masks and social distancing.

That should be an easy pill to swallow, if only we could come to believe it’s not poison.