COVID-19 is the third leading cause of death in the United States, after cancer and heart disease. The University of Washington’s Institute for Health Metrics andEvaluation has published truly disheartening mortality projections resulting from the fall/winter surge. The daily death toll will reach 2,250 (approximately three times higher than now) by mid-January. Cumulative deaths by February 1 could reach 514,000 if states do not enact social distancing mandates.
Most every healthcare professional is incredulous that the national COVID-19 conversation has become politicized. Recent polling (November 8) from Civiqs shows that on the question of whether a given respondent is “extremely concerned” about the coronavirus, the national divide between Democrats and Republicans, respectively, is 61 percent to 7 percent. By that same token, just 2 percent of Democrats are “not concerned at all,” while 33 percent of Republicans fit in that bucket.
As healthcare marketers, how do we speak to those individuals who are not sufficiently concerned about COVID-19? Reaching them is critical as adherence to social distancing, mask wearing, decreased mobility and more frequent hand washing will undeniably reduce morbidity and mortality.
By employing strategic communications that recognize the power of cultural cognition, you can break down the polarized barriers affecting compliance and acceptance of personal responsibility. Communications must be informative, non-judgmental, personal and anecdotal — the sort of evidence our brains tend to favor over that which is more abstract and statistical in nature. You must bring the consequences of the pandemic to light and simultaneously encourage strategies to slow the spread.
First, we must understand the concept of “cultural cognition.” This “refers to the tendency of individuals to conform their beliefs about disputed matters of fact to values that define their cultural identities”. Like climate change or the Black Lives Matter movement, COVID-19 has become so entwined with people’s political identification that any information that suggests the disease is real and deadly threatens the status quo of many political conservatives’ core beliefs. When our beliefs are threatened, we find ways to minimize or dismiss that information (e.g., citing ‘fake news’). Asking someone to change their mind about these subjects also entails a threat to their social and political identity. Their identity serves as something of an anchor, preventing their opinion from drifting too far from where it presently sits.
By employing strategic communications that recognize the power of cultural cognition, you can break down the polarized barriers affecting compliance and acceptance of personal responsibility. Communications must be informative, non-judgmental, personal and anecdotal — the sort of evidence our brains tend to favor over that which is more abstract and statistical in nature. You must bring the consequences of the pandemic to light and simultaneously encourage strategies to slow the spread. Importantly, you have a duty to address the conspiracy theories that perpetuate the denial of the pandemic’s reality.
Here are some suggestions:
- Show empathy for your audience. Tailor your messaging to reach those who may not believe the virus is a real threat. And, reach out to those who may believe it, but don’t have the knowledge to deal with it effectively. Remember that social, educational and economic disparities matter – not everyone has the same access to information, resources and support.
- Counter misconceptions that may have been created early in the pandemic. For example, at first, recommendations were that only sick people and healthcare workers should wear masks, but now it’s recommended for everyone. Remind readers that 1) COVID cases are not rising because of increased testing (the increase in percentage of positive results is key); 2) herd immunity requires that 70% of the US population would have to recover from the disease but would result in millions of deaths and an overwhelmed health care system; and 3) COVID is more contagious than the flu, causing severe illness such as lung injury, blood clots and multisystem inflammatory syndrome in children. Last, COVID has a higher mortality rate.
- Counter doubt towards experts and scientific institutions. Work to build trust within your communities by emphasizing that doctors and public health leaders have their best interests in mind. You may need to acknowledge where they were wrong before but were using the best available information at that time.
- Counter the notion that healthcare professionals find financial incentives in caring for COVID patients. Patients are labeled with COVID-19 to track cases and then take the quick action necessary to prevent further spread. If a patient has a history of heart disease or other medical problems, and dies in the hospital with COVID-19, it is clear that coronavirus exacerbated that underlying condition — and their demise. It is accurate to list it as a cause of death.
- Carefully relate that physician practices are not immune to the economic losses Americans are experiencing.One in five American physicians, whether salaried or in independent practice, have experienced pay cuts during the pandemic. Hospitals and physician practices have implemented furloughs and layoffs to stay afloat, including furloughs at 35% of all primary care offices. More than 16,000 — or 9% — of independent physician practices have had to close entirely.
- Discuss number of ICU beds filled, impact on everyday admissions, bed shortages, PPE needs and the financial hardship the pandemic is creating for your organization. Help your leaders to offer messages regarding hospital finances. Recent estimates suggest that hospitals, thanks to the loss of elective surgeries during pandemic spikes, will face over $300 billion in lost revenue this year alone.
- Tell stories of how the pandemic is affecting your staff. Discuss staffing shortages, risk of exposure to caregivers, exhaustion, sacrifice and exemplary service. The extreme sadness that families are living through with the loss of a loved one is perhaps matched only in its tragedy by the impact of COVID on hospital systems. The COVID-19 pandemic is putting healthcare professionals working in critical care under extreme pressure. The scarcity of resources such as personal protective equipment, ICU beds, and ventilators, increase this psychological burden. Front-line nurses experience huge workloads, long-term fatigue, infection threat, and frustration with the death of patients and grieving families.
- Remind your audience that activities like washing hands or keeping distance from someone with any virus is already a well-established disease prevention strategy. This time, the virus is much more dangerous than the regular flu and therefore, extraordinary measures must be taken. Make sure people don’t feel fearful or helpless but instead feel empowered to do small but important actions. Help them to understand that, if each one does what they can, they can protect their community.
- Last, remind your audience that our behavior is the most effective and powerful treatment available to us at this time. High levels of compliance with preventive measures could potentially turn this outbreak around. Evidence for this has been shown both in the United States where states with more masking and social distancing and delayed re-openings have seen significant reductions in morbidity. Countries like South Korea, New Zealand and Australia are close to being COVID free.
Please embrace your role as a critical communicator in this crisis. Until there is widespread distribution of a vaccine, the behaviors you effect have a bigger role to play than medical science.
James is a regular contributor to communications created by the Wisconsin Healthcare Public Relations & Marketing Society. This article is excerpted from his original essay here.