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Why are Americans confused about COVID? Blame it on poor communication.

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Americans don't trust their public health experts, a serious problem in the best of times but downright dangerous amid a pandemic. Just 44% of Americans trust in the Centers of Disease Control and Prevention, while only 40% trust Dr. Anthony Fauci (the nation's point man on all things COVID) according to an NBC News survey conducted this month. Trust in politicians is even lower.

It's perfectly understandable why Americans feel this way. At all levels, our public health agencies have been using contradicting claims and supposition masquerading as fact. And it's not hard to diagnose the root of the problem. To quote the Captain's speech in "Cool Hand Luke," "what we've got here is failure to communicate."

Trust and public health

Trust can be rebuilt, but it starts with stronger communication.

Compounding the problem are politicians and partisan figures eager to pounce on every misstatement to push their own agenda at the expense of Americans' safety.

A perfect example is the recommendation by the CDC for COVID-infected Americans to isolate for only five days instead of 10. Fauci, director of the National Institute of Allergy and Infectious Diseases, and Surgeon General Vivek Murthy had publicly questioned that advice, causing the CDC to tweak it.

Speaking for exasperated Americans everywhere, a CNN reporter asked CDC Director Rochelle Walensky in the wake of her agency's flip-flop: "How do you expect people to keep track of what they can and can't do?"

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Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, answers questions at a Senate Health, Education, Labor and Pensions Committee hearing on Jan. 11, 2022.
Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, answers questions at a Senate Health, Education, Labor and Pensions Committee hearing on Jan. 11, 2022.

In her answer, Walensky talked about another deadline, the seven-day period for which the test is good.

The simple answer is it's impossible for the nation to keep track of anything – at least not when one agency says one thing and another says something else. Interagency coordination would help ensure consistent messaging – even on little things. Just recently we saw Walensky double masked at a congressional hearing while Fauci was occasionally maskless. People noticed.

This is not partisan criticism.

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Poor communication is a problem that has spanned both the Trump and Biden administrations, as well as authorities in red, blue and purple states. Public health officials went from "masks do not work for the general public" (former Surgeon General Jerome Adams) to "we have clear scientific evidence they (masks) work, and they are our best defense" (former CDC Director Robert Redfield) back to "a single-layer cloth mask just isn't cutting it" (Adams). This kind of shifting advice has made protecting public health and safety more difficult, leading people to turn to armchair immunologists for answers.

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To her credit, Walensky has recognized that public communication is a critical component of public health and has sought professional communications coaching, according to The Washington Post.

Crisis communication principles

But regaining trust is much more difficult than establishing it at the outset and then maintaining it. Here are some timeless crisis communications principles that all public health agencies, and political leaders, should follow if they hope to build trust with the public going forward:

►Do no harm. We are all familiar with the Hippocratic oath. It calls for doctors to first do no harm. The same should apply to public health officials. That means trying to convince your audience instead of trying to manipulate them. Manipulation is about controlling people through distortions rather than education. As it turns out, the original guidance telling the public not to wear masks was driven not by science but to prevent a run on N95 masks. In other words, it was manipulative.

►Use caution with projection models. Public health officials should avoid trying to sound like they have all the answers. Science is a process of inquiry and investigation, testing hypotheses and examining evidence. Especially when dealing with a new disease, it is inevitable we will not know everything. For example, early in the pandemic public health officials put far too much credence in predictive models that proved embarrassingly wrong. They used those models to create a sense of optimism – a worthy goal, but one that can lead to cynicism if predictions do not pan out.

Models can be useful internal tools to plan strategy but can come back to haunt you if you make too much of them. Case in point, Dr. Deborah Birx, former White House coronavirus coordinator, touting a model out of the University of Washington's Institute for Health Metrics and Evaluation that severely underestimated the death toll. Within just a month, it had proved wrong, disastrously so. Even her own statements about it showed how unreliable it was.

"Look how much the model has changed in just a week," Birx said in April 2020. "Remember just a week ago it was 80,000 (dead), now it's 60,000." Today, America's actual COVID-19 death toll is about 867,000.

►Don't overpromise. There are findings that public health officials may believe to be true based on the best current knowledge, but those same findings might at some point prove to be false. For example, Walensky said this last spring: "Our data from the CDC today suggests that vaccinated people don't carry the virus, don't get sick."

Of course, with omicron now infecting both the vaccinated and the unvaccinated, those past statements have fueled vaccine skeptics. Granted, many times Walensky and Fauci have used qualifiers to avoid definitive statements. But it only takes one off statement to create confusion. Discipline in messaging is critical, as is immediately correcting statements that are flat out wrong or may be misconstrued.

►Don't hype the threat, or sugarcoat bad news. Americans can't take it. We expect spin from politicians and self-serving rhetoric from corporations. We don't expect or want a similar runaround from public health agencies we rely on to help keep us and our families safe. Be straight with us, even if the news is bad. Tell us how you plan to make things better.

►Don't demonize people. It would be odd for a political candidate to expect to win by telling persuadable voters, "If you don't vote for me, you’re being selfish and don't care about your neighbor." Yet that is pretty much the approach some public officials and political leaders have taken when it comes to vaccine skeptics. California Gov. Gavin Newsom even compared people who refused the vaccine to drunken drivers. A better approach is to be empathetic, data-driven and educational – not bullying or condescending.

Continuing to treat public health as just another political battleground will only lead to half the country tuning out important information that could save their lives. Health care is about people, not politics. Don't manipulate your audience, be honest about what you know and don't know, coordinate with other agencies, don't overpromise, stay disciplined, be humble and, above all, keep politics out of it. That's the only way to win back the trust of Americans.

James Davis, founder and president of Touchdown Strategies, is a public affairs professional with decades of communications experience dealing with war, floods, oil spills, political conventions and other crisis communications.

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This article originally appeared on USA TODAY: CDC needs to improve its COVID messaging. Here's how it can do better.