What Have We Learned from COVID-19?

June 2020

Peter M. Sandman, one of the world’s preeminent risk communications consultants, is the creator of the “Risk=Hazard+Outrage” formula and a frequent speaker and author on managing crises and controversies. A Rutgers University professor from 1977 to 1995, Dr. Sandman, who received his Ph.D. in communication from Stanford University, became a full-time consultant in 1995.

In late May, Impact interviewed him by email about the way the public and private sectors have responded to the pandemic — and what we have learned from the experience that should guide us in the future. This is the first of two parts to this wide-ranging and insightful interview. The second will appear in our July/August issue.

You were talking about the pandemic as early as the first week of February, if not before. What were you observing then about the way the government and the private sector were preparing for or communicating about the pandemic that concerned you?

Although it looked early on like the virus would spread globally, it wasn’t obvious at first how severe the COVID-19 pandemic would be. So the right message would have been about preparedness, logistical and emotional, for the hard time that might be coming.

But experts and officials — even those who knew a severe pandemic was a distinct possibility — chose instead to reassure the public. Alas, to everyone’s subsequent dismay, they succeeded. Many leaders, including WHO Director General Tedros Adhanom Ghebreyesus and New York Governor Andrew Cuomo, said that fear or hysteria was worse than the virus. They were worried about public panic. So they validated the public’s complacency, and left us incredibly unprepared.

The “us” they left unprepared includes most corporate leaders, who paid far too much attention to official claims that the risk was low — and far too little attention to their own risk matrices. Nearly every company of significant size has taken enterprise risk management onboard, and nearly every enterprise risk management effort incorporates a probability-by-magnitude matrix to help management identify risks worth mitigating. Those matrices teach that a risk with a devastatingly high magnitude deserves increasing amounts of preparedness effort as its estimated short-term probability rises from very low to low toward moderate.

And to a large extent public health officials bought into their own over-reassurances.  They, too, failed to prepare, and failed to convince their political bosses to prepare.

All this came about when public trust in institutions — in business as well as government — is at a low point. To what extent has this made pre-crisis planning and crisis communications difficult?

It is possible that low trust would have prevented the public from heeding warnings about a possibly severe COVID-19 pandemic to come. It’s hard to know, since there were so few such warnings.

Certainly low trust didn’t keep the public from heeding all those over-reassurances.  Wouldn’t it have been wonderful if more people had mistrusted all those officials who said “nothing for you to worry about” and prepared anyway!

I do think the public health establishment may have worried about a boy-who-cried-wolf mistrust problem. There have been a bunch of pandemic false alarms – most notably bird flu (the pandemic that didn’t happen) and swine flu (the pandemic that turned out milder than a typical flu season). It’s not so much that experts and officials were worried that their COVID-19 warnings might be mistrusted and therefore ignored. I suspect they were worried that COVID-19, too, might fizzle, and they’d be accused of alarmism yet again – and future warnings might be mistrusted. So they held their fire.

As for communications at the height of the pandemic crisis (so far), in mid-crisis the public tends to set aside any mistrust “for the duration” and follow instructions. So it’s not surprising that lockdown cooperation exceeded the expectations of the modelers. If anything, I think the majority of the public trusted the architects of lockdown too much.

Despite the survey evidence, I’m not convinced we’re in a period of low trust. I’d say it’s more polarized trust. Each side trusts its own leadership and its own media excessively, and it misses or dismisses the other side’s share of the truth.

Did this take business by surprise?

Yes. But that’s not a fair question. A once-in-a-century black swan is supposed to take us by surprise. Of course a severe pandemic was on everybody’s list of low-probability high-magnitude risks that might eventually engulf us. But everybody also knew that the moment it did so would come as a surprise.

Maybe business should have done more long-term pandemic preparedness. But decades ago I was convinced by the late Aaron Wildavsky that preparing specifically for unlikely risks is a bad investment. There are too many unlikely risks; you usually find you wasted resources preparing for the wrong ones. Wildavsky understood that as an unlikely risk starts looking less unlikely, the case for just-in-time preparedness strengthens. Until then, he argued, both businesses and governments should build in more capacity for all-hazards resilience instead of trying to guess which unlikely disasters are going to materialize. Rather than asking how prepared companies were, maybe we should be asking how resilient they were.

But Wuhan in January was a real-world heads-up. A novel virus was already devastating a big city in a way the world hasn’t seen since the Spanish Flu, if then. Wuhan might have turned out to be a false alarm, of course, but it was certainly an alarm. It meant a severe pandemic was no longer a long-term low-probability risk, but now a short-term risk of middling probability. Wuhan should have been enough to get corporate risk managers and CEOs to dig out, update, and begin implementing their pandemic plans – in January or early February at the latest, not in March. In most cases that didn’t happen.

You have also written that government routinely misleads the public and gets away with it, where CEOs would not. Can you explain?

One of the things I learned consulting for corporations, governments, and activist groups is that “the good guys” tend to be more dishonest in their public communications than “the bad guys.” There are at least three reasons:

1. Organizations that are trying to help save the world feel entitled to say misleading things in pursuit of their pro-social goals. Organizations merely trying to earn a profit don’t feel so entitled.
2. Organizations that are trying to save the world are less likely to get caught in their dishonesties than organizations merely trying to earn a profit. Journalists and even prosecutors don’t scrutinize their claims as skeptically.
3. When we learn that organizations that are trying to save the world have misled us, we tend to forgive them. When we catch profit-making organizations in the same sorts of misbehaviors, we tend to crucify them.

What mistakes have you seen companies and nonprofits make?

In 2005-2007, fears of a horrific bird flu pandemic were widespread among experts, officials, and the general public. I worked on pandemic preparedness and pandemic planning with scores of companies and nonprofits (and governments too). I wrote articles for my website on various aspects of pandemic communication, including a long, four-part article on “What to Say When a Pandemic Looks Imminent.”

The bird flu pandemic never happened (so far, anyway), and the swine flu pandemic of 2009-2010 was mild — so 2020 was the first opportunity for companies and nonprofits to dust off and implement their bird flu pandemic plans.

To the best of my knowledge, they didn’t.

I’m not especially critical of how companies and nonprofits have weathered the pandemic crisis itself. We’re all muddling through as best we can. Most organizations are doing as well as could be expected. Some – many, even – are doing better than could be expected.  An important exception: companies that have shown a callous disregard for their lowest-paid employees.

But virtually all companies and nonprofits missed the pre-crisis opportunity to prepare themselves, their employees and their stakeholders. The World Health Organization declared COVID-19 to be a Public Health Emergency of International Concern on January 30. By then, government officials in the U.S. and elsewhere were issuing mixed warnings and reassurances: It might get bad, but it’s no big deal now; we’re preparing just in case but the public doesn’t need to worry about it. That should have been signal enough for companies and nonprofits to do things like this:

• Update their pandemic plans and decide which elements to implement now.
• Cross-train employees as a hedge against pandemic absenteeism.
• Build an organizational stockpile of personal protective equipment.
• Decide which operations can be shut down in a crisis, which can be run from home or other remote locations, and which must be sustained on-site despite the risks.
• Alert employees to the preparations they might want to be making at home, such as thinking through childcare plans and stockpiling medicines and other supplies.
• Start planning social distancing measures and other ways of operating more safely during a respiratory disease outbreak.
• Brief all stakeholders and especially employees on what the organization is doing to prepare, and what it expects to do if a severe pandemic materializes.

Are organizations beginning to get it right?

Organizations that aren’t front-and-center in the pandemic (the way hospitals and nursing homes are, for example) need to balance three priorities in both their communications and their actions:

Priority One is surviving. They can’t do any good for anyone if they go out of business. I’m sure organizations haven’t forgotten to think about their own survival, but I wonder if some have forgotten to communicate sufficiently about it. Employees worried about their jobs might worry less if they knew more about what their employers were doing to keep the organization alive.

Priority Two is helping.  In crisis situations, more than in ordinary times, stakeholders want to see organizations finding ways to help — whether it’s manufacturing ventilators or delivering meals. I think many organizations are getting this right, and those that aren’t will pay a price down the road.

Priority Three is the toughest: balancing concerns about COVID-19 infection with concerns about everything else we hold dear, from jobs to freedom to mental health.  Many of our most visible leaders and communicators have so far failed this balancing test. For at least the next couple of years, the “new normal” will be all about balance: living with SARS-CoV-2 (the virus that causes COVID-19); resurrecting our economy and way of life while protecting the vulnerable and keeping hospitals from getting overwhelmed. The same balancing act will be required within every organization — finding ways to do what you do while being neither cavalier about the virus nor obsessed with it. Very few of us are getting this right yet.

There seems to be only two ways to view this — either “science” or as the “economy.” How do we work in ways that don’t ask people to choose a side, like one is right and the other wrong?

I hate it when officials claim to be adhering strictly to “the Science.” COVID-19 science keeps changing and is hotly debated. Moreover, the key pandemic management questions go far beyond science. “How safe is safe enough?” isn’t a scientific question. Neither is how best to balance saving the most lives and saving the most of our way of life. These are political questions in the best sense of the word – questions officials need to answer with due deference to the interests and opinions of the body politic (that is, the public). Officials who aren’t listening to scientists are irresponsible. So are officials who give scientists their proxy.

And officials who quite properly pay attention to their constituents while claiming they are guided solely by “the Science” are dishonest.

Economic concerns and health concerns are inextricably linked – in both directions. The health impacts of lockdown and economic devastation are huge: depression and suicide, addiction, domestic violence, etc. Poverty and chronic anxiety are known killers. It is equally true that you can’t resurrect the economy if people are afraid to shop or go to work. So managing the COVID-19 pandemic is crucial to economic revival, and reviving the economy is crucial to public health.

And neither is possible without effective communication. If people don’t believe their officials can manage the pandemic adequately, they won’t fully reenter the economy. If people don’t believe their officials can do what it takes to resurrect the economy, their health will suffer, and so will their willingness to comply with social distancing strictures.

CNN and MSNBC routinely tell us what the administration is doing wrong. What if anything is the administration doing right?

Pandemics are global by definition, but pandemic viruses reach different communities at different times in different intensities – so pandemic planning has always been all about “targeted and layered” local interventions in response to local conditions. President Trump was right to see COVID-19 as something to be managed mostly by governors and mayors and their state and local health departments.

Some pandemic-related tasks needed to be federal: building test capacity; manufacturing and distributing personal protective equipment; managing the search for vaccines and therapeutics; distilling research findings into actionable guidelines. These tasks were carried out with vastly more controversy and turmoil because of dysfunction in the executive branch. There were obvious failures and insufficiently recognized successes.  The most unarguable failure: not uniting the country through determined, informed, empathic leadership in the White House.

The main thing the Trump administration did right was to leave state and local authorities in control. Somehow we blundered anyway into a nearly nationwide lockdown – a lockdown that probably made sense in places where the virus was already spreading explosively but was by definition excessive in places where less extreme “targeted, layered” measures could have done the job. Many states seem to be doing better at addressing local conditions in their criteria for coming out of lockdown, though I can’t tell yet how successfully they will identify and respond to clusters and resurgences.

Different state and local leaders are excelling and failing at different aspects of pandemic management. I wish contact tracing capacity were further along than it is. I wish more had been done to protect people in nursing homes and other congregate settings. And in my own area of expertise, risk communication, I wish state and local leaders were doing more to help their publics find the right balance between avoiding infection and other priorities.

How has the CDC handled it?

The CDC’s biggest failure was not pulling out all the stops to make sure the U.S. had an adequate COVID-19 testing capacity as early as possible. The agency chose to develop its own test, and for crucial weeks, its test didn’t work properly. It compounded the problem by not having a backup plan; not adopting another country’s test; and not pushing the FDA to allow states, hospitals, and private labs to develop their own tests.  And to date it has never apologized for the testing debacle.

I think this debacle set the stage for everyone to single out the CDC for blame about other things that weren’t necessarily its fault. Pretty much the entire public health establishment was vehemently opposed to people wearing masks in ordinary life until suddenly (long after asymptomatic and pre-symptomatic spread was a known problem), it was just as vehemently opposed to people not wearing masks in ordinary life. That reversal is usually, unfairly laid at the CDC’s door.

It didn’t help that the CDC visibly lost the confidence of President Trump. The testing debacle undoubtedly contributed to that, but the key moment came on February 25, when the CDC’s Nancy Messonnier warned the media that because of COVID-19, “disruption to everyday life may be severe.” She apparently didn’t ask the president’s okay, didn’t even give him a heads-up. The stock market tanked, and so did the CDC’s standing with the White House.

Despite all of the above, the CDC continues to be an indispensable source of guidance to state health departments, governors, clinicians, industry sectors, etc. Though the White House no longer lets the CDC do COVID-19 press briefings, the agency still does just about everything else it has done in past public health emergencies.

In our July/August issue: What your organization can do to minimize your pandemic risk going forward.

Reach Sandman at [email protected] or 718.208.6271.