Public health is now grappling with the most severe COVID threat: the “I don’t give a damn” variant. While some mask up, most people do not, and we have returned to holding and attending big social gatherings. People’s ambivalence to safety is indicative of communications that failed to unite the public around measures that reduce the spread of COVID. That bout has been lost, but as the saying goes, “sometimes you just have to roll with the punches.”

There are many reasons for the failure to convince people to take sensible preventive measures. Still, a significant cause of COVID’s blow to the authorities’ credibility is that the time is over for the one-size-fits-all messages that characterized successful public health campaigns of the past. They have been notably ineffective at a time when anyone with an edgy opinion and a Twitter account is a tribal influencer. With just 240 characters, a naysayer can completely counter science when their audience unleashes a cascade of likes and retweets.

Stop Shadowboxing

The government, especially The Centers for Disease Control (CDC) and the scientific community can overcome the damage to their credibility by going small.  Focusing on specific targets and “micro-communicating,” officials and scientists can speak directly to those with the most to lose: their lives. These are the audiences with real skin in the game.

From the earliest stages of the pandemic until now, COVID hospitalizations have been six times higher and deaths 12 times higher for people with underlying medical conditions such as diabetes, heart disease, or chronic lung disease. Currently, 81% of COVID deaths occur in people over age 65. The number of deaths among people over age 65 is 97 times higher than that among people ages 18-29.

Broad messaging now flies over most people’s heads. It’s certainly doesn’t speak to patients who are BIPOC, seniors and rural Americans, patients who are struggling the most to access this nation’s health system and who are also the most at risk during viral fall-out. Their lives are on the line as we learn from communication missteps and prepare for the next pandemic.

For example, consider the brutal truth about one of the deadliest comorbidities in the COVID at-risk community: people with diabetes.

• Diabetes disproportionately affects racial/ethnic minority populations. Compared with white adults, the risk of having a diabetes diagnosis is 77% higher among African Americans, 66% higher among Latinos/Hispanics, and 18% higher among Asian Americans
• Diabetes prevalence is approximately 17% higher in rural areas than in urban areas, with studies showing that rural adults were more likely to report a diagnosis of diabetes than urban counterparts
• Some 33% of adults aged 65 or older have prediabetes or Type 2 diabetes. This age group is more at risk of developing diabetes-related complications like low blood sugar, kidney failure, and heart disease than younger people.

The CDC and other players must aggressively engage in conversations with these most vulnerable audiences. They must learn to target their messages and hone their digital marketing savvy to reach them and the patient coalitions that tap into other groups’ grassroots reach.

Part of the Problem is that Primary Care May Have Thrown in the Towel

The pressing public health threat of COVID took place just as our front-line medical defense force — primary care —was in retreat. Primary care is morphing before our eyes into a pharmacy convenience-store service plug-in. And while the ability to walk into a CVS MinuteClinic, Walgreen DR Walk-In, or Walmart Care Clinic for primary care is in many cases a win for access to care, it presents a challenge for communicators.

Today, fewer and fewer people have a long-term family physician who tracks their needs and feels responsible for their longevity. The single-practitioner office is now being absorbed into larger practice groups and private practices are vanishing. Without that relationship with a trusted healthcare provider, patients are missing out on the immediacy of personalized advice.

The CDC and other public health authorities must consider that a key communications ally has changed locations, and the forwarding address might be community-based retail pharmacies.

Communicators Need to Change their Game to Win in this Ring

A learned medical advisor — whether an in-person physician advocate or one powered by smart technology — who knows our name and what’s happening with us over time still matters. It is the best defense against diabetes and other chronic conditions and the threat posed by deadly viruses when coupled with those preexisting conditions. Even in the changing medical landscape still struggling to overcome COVID-19 and the unresolved challenges of racism that result in illness and death, there must always be a place for that relationship. Otherwise, the ticking time bomb of millions of Americans with preexisting conditions will morph into an overwhelming public health crisis when the next pandemic hits.

CDC must now think smarter and partner with major patient-centered not-for-profit groups such as the American Cancer Society, American Diabetes Association, and American Heart Association so that they can take on the primary conversation role with their communities. 

And they must forge even stronger ties with the retail community and long-term care senior pharmacy networks to fill the communications role once played by family physicians, a vital link in conveying the importance of information on public health imperatives, especially those related to combatting viral epidemics.

Down But Not Out – CDC Knows the Ropes

CDC must use the time we have now to train for the next round. Unfortunately, there will be another fight against a viral opponent soon enough, though we can’t predict when. But like any determined fighter would, our public health players must head train and spar with proven communication players to perfect how and to whom they communicate their scientific data and life-saving guidance. What’s at stake is a world title for our survival.