IIn today’s corrupt political environment, it’s no surprise that trust in government is near an all-time low. That’s a big problem. Communities that have shown greater trust during the COVID-19 pandemic have experienced fewer deaths and less economic damage.

In many countries, especially the United States, the pandemic has disrupted trust between sections of the community and the public health system. How can we restore that trust? In a word, gradually. Trust is built in drops and lost in buckets.

I believe that in order to restore trust, we need to prioritize the following three actions:

• improved communication
• Make guidance and obligations limited, relevant and transparent
• Demonstrates steady progress on health issues important to people

The decline in trust in science, especially the Centers for Disease Control and Prevention, is large, dangerous, and largely partisan. Americans’ overall trust in scientific expertise did not change significantly between 2016 and 2020, but the proportion of people with both low and high trust increased, and the proportion of people with both low and high trust increased. The proportion of people with trust has decreased significantly. There was a slightly larger shift toward increasing trust than distrust, but trust and distrust became deeper and more entrenched at both ends of the spectrum.

Between January 2019 and October 2023, the share of adults who have little or no trust in scientists more than doubled among Republicans, from 18% to 38%. Among Democrats, only 9% (half the Republican baseline) had little or no trust in scientists, and that rose slightly to 13%. From December 2020 to April 2022, Republican trust in the CDC’s new vaccine information declined from 57% to 41%, while Democratic trust, which was initially high (88%), remained high (89%). %). Rather than creating this partisan divide, the coronavirus has deepened it.

Excess deaths during the pandemic were 43% higher among Republicans, largely due to lower vaccination rates. From health warnings to recommendations on everything from contaminated food to extreme weather events to the next pandemic, illnesses and deaths that could have been avoided if more people didn’t trust public health advice. , economic losses will occur.

failure of communication

During the COVID-19 pandemic, inconsistent and ineffective messaging has increased the politicization of public health and distrust of government institutions. This wasn’t entirely the CDC’s fault. Nancy Messonnier, the agency’s chief scientist for respiratory viruses, spoke frankly, clearly and aptly in February and early March 2020, when the coronavirus spread across the United States. The White House then silenced her, and so did the CDC for the rest of 2020. Government agencies certainly cannot communicate well if they are not allowed to do so.

Communication needs to be timely, accurate and informative, using appropriate messengers and messages. “Be first, right, and trusted” is CDC’s crisis communications motto. Public health officials must speak up about what they know, when they know it, and their facts and opinions. Exaggerating your claims undermines trust.

The Biden administration has exacerbated the problem by tying messages from the CDC and the White House. This effectively ensured that a large segment of the population would distrust the CDC’s health warnings.

The CDC also made mistakes. Communication was sometimes unnecessarily complex and not transparent enough.

Good communication is a two-way street. listening, understanding, empathizing, addressing concerns, and speaking. During the pandemic, many people with legitimate concerns felt they were being ignored.

It is essential that public health communications be free from political interference and be seen as free from political interference. The thousands of CDC doctors and scientists who have spent decades becoming world experts in their fields are not political appointees. These are people who have dedicated their lives to public health and whose information helps people protect themselves and their families.

But communication alone, no matter how effective, cannot restore trust.

guidance and duties

CDC communicates data such as case definitions, number of cases, risk factors, and epidemiological findings. These are technical, scientific findings, and government agencies should be free from political interference in order to speak frankly and openly about the facts.

The CDC also provides guidance to clinicians. A good model is the CDC’s Advisory Committee on Immunization Practices (ACIP). All ACIP presentations, deliberations, and conclusions are publicly available, recorded, and available online. Decisions are based on meticulous documentation of scientific findings and incorporate the input of diverse stakeholders. This committee is independent, and the CDC then makes these recommendations (but rarely deviates from them).

However, guidance on public behavior, such as wearing masks or closing businesses and schools, represents a completely different process. Broad policy guidance should be based on science, but policy decisions should be made transparently by political leaders informed by public health experts. Missions must be rare, appropriate, nuanced by time and place, and led by local decision-makers. Even in the face of identical epidemiological data, two communities may make different decisions about whether and when to close schools, businesses, and public gatherings and activities. It is appropriate, and empowering communities to make these decisions is essential to increasing public acceptance.

CDC must ensure that feedback from clinicians, patients, families, affected organizations, and others is heard and documented in publicly accessible records. Government agencies must also consider economic and social realities, as ACIP does on a daily basis. The methodology, rationale, scientific basis, and recommendations should be clearly and concisely explained.

progress towards trust

There is nothing like success. Public health must protect and improve health in ways that people recognize and value. You also need to demonstrate that. Better prevention and treatment of opiate addiction. Safe and clean food, water and air. Reduced risk of cancer, heart disease, and stroke. Practical health information relevant to your community.

Governments, businesses, and healthcare organizations all have a critical role to play in communicating effectively with broad populations who need to protect themselves, their families, and their communities. Trust in the private sector is high and has increased significantly in recent years. Public-private partnerships can work, as exemplified by Operation Warp Speed, which delivered a safe and effective COVID-19 vaccine in record time. Improving primary health care is essential. Healthy people are more resistant to infectious diseases. Doctors and nurses continue to be highly trusted sources of information, allowing frontline clinicians to sound the alarm about emerging health threats and provide treatments and vaccines in an efficient and acceptable manner.

The more trust you build, the more quickly and effectively your country will be able to respond to emergencies. Restoring trust may not be quick or easy, especially in a season of political conflict, but that does not make it any less important. The word trust comes from the word strength. The more we can earn each other’s trust, the stronger each of us and our society will become.

Dr. Tom Frieden is president and CEO of Resolve to Save Lives, a nonprofit organization that partners with countries to make the world safer from infectious diseases and prevent deaths from heart attacks and strokes. He served as director of the Centers for Disease Control and Prevention from 2009 until 2017, where he oversaw responses to the H1N1 influenza, Ebola, and Zika outbreaks.