Information and its Communication: The Foundation of Public Health Response

The COVID-19 storm made a powerful landfall in the United States and whipped up the social media winds slinging articles, guidelines, hot takes, and press releases at our squinting faces like a million specks of sand. The White House began to host daily press conferences. County public health departments put out recommendations that, at times, differed from their neighboring counties. Dueling epidemiological models made headlines of major news outlets.

This public health threat has made one thing clear: accurate information – and its clear communication – has never been more important.

Canadian Prime Minister Justin Trudeau agrees: “Right now it’s more important than ever that Canadians have access to the latest news and information.” As does the World Health Organization. Health information systems comprise one of the World Health Organization’s six essential building blocks of an effective health system.

First, there is the population-level and epidemiologic data. Where are the COVID-19 cases thus far? How many tests are positive? How frequently do those positive cases require hospitalization or critical care? What is the true case fatality rate? These numbers from China, South Korea, Singapore, and Italy, among others, inform epidemiological models, and have the potential to influence key decisions here in the US or in other countries preparing their own response. 

Then, there are the basics of the disease itself. Never previously documented in humans, such information is hard to come by. How long is the incubation period? How does it spread? How, if at all, is this transmitted between humans? What protective equipment is essential for frontline health workers? What symptoms does it cause, and thus, what’s the case definition? The critical answers to these ensure patients and their health workers can identify cases, isolate them if necessary, and prevent the spread throughout a community. 

Finally, beyond collecting the above information there is the communication of that information, plus general public health practices to be followed, to a public of varying levels of health literacy. These messages are delivered by the president, governors, mayors, leaders of federal health agencies, and state and county public health officials, and they are conveyed through multiple channels including television and social media. There has never been a more fruitful nor anxiety-provoking time to be on Twitter. 

But what if there is conflicting information? What if communications from leaders lack clarity, despite perhaps the accuracy of the data itself? How does that affect decision-making among key leaders? How does that affect public behavior? How does that influence frontline health care workers?

The crushing economic fallout from the COVID-19 pandemic has unfortunately resulted in millions of Americans seeking unemployment benefits and has, thus far, required multiple US governmental economic rescue packages. This is an unnecessary and painful way to learn our lesson: the US response could have benefited from stronger information collection, organization, and dissemination. 

This ought to serve as a wake-up call to those of us working to produce and distribute meaningful data. Data used to create, collect, and disseminate health metrics can affect the resource allocation to – and behavior within – all entities in a health system, including for uses outside a global pandemic, and thus careful attention to these efforts is required. There is perhaps nothing more powerful to reinforce this than a pandemic.

Beyond the aforementioned lessons learned, a primary possible silver lining is that this will help create the quantifiable business case for dependable health information and pandemic preparedness. The return-on-investment in sound public health should never again be questioned.

This public health crisis and its response have relied heavily on the collection and reporting of information. This novel coronavirus has exposed some of the US public health system’s greatest deficiencies. Perhaps most critically, it serves as a compelling reminder that reliable information communicated effectively should be the foundation on which any future public health response is built.

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