In 1925, a tornado cut a track hundreds of miles long, flattening schools and houses across three Midwestern states. At points, the storm was nearly a mile wide and appeared to observers not as a thin funnel but as a wall of angry clouds. Nearly 700 people lost their lives, making it the deadliest tornado in U.S. history.
The tragedy was compounded by an astounding error of human judgment. At the time, it was taboo for weather scientists to forecast tornadoes in public communication. Experts feared that such a warning would cause unnecessary disruption or panic if the tornado didn’t materialize. Residents in the path of the tornado were caught by surprise.
The justifications for this prohibition may sound familiar to those who remember the early days of the Covid-19 pandemic, when senior health officials repeatedly assured that risk to the American public was low. One skeptic of the weather community’s duty to warn of tornadoes argued that “the stoppage of business and the unnecessary fright” would be “worse than the storms themselves.” Another warned of the health hazards to people sheltering in damp basements. A desire to prevent panic predominated — as it too often does in the case of outbreaks. Public health officials can learn from how the weather community corrected these mistakes.
Today, a prohibition on storm warnings would be unthinkable. When a tornado is sighted, push alerts light up smartphones, sirens sound from parking lots and ball fields and urgent warnings interrupt television programming. These precautions do not apply solely to clear and imminent threats. Storm forecasters draw attention to hurricanes forming offshore well before the storms fully take shape, as they did last week with Hurricane Helene, updating the public as the threat develops and preparing them for protective action.
Public health communications often take a different approach, choosing conservatism over a duty to warn. At the start of the 2022 mpox outbreak, U.S. health officials went out of their way to avoid naming sexual contact among men who have sex with men as the primary risk factor spread, out of fear of creating stigma. While these concerns have merit, people were left to puzzle through the outbreak without the guidance they needed to make decisions to protect themselves.
Or take a recent case of a Missouri resident who was hospitalized with avian influenza A (H5N1). The person reportedly does not work with animals, does not drink raw milk and has no other obvious connection to known sources of the virus. After describing it as a “one-off case,” public health officials acknowledged that a household contact and at least six health care workers who cared for the patient also experienced symptoms of a possible viral infection. Investigators are running tests to determine whether they, too, were infected. Despite these concerning developments, the Centers for Disease Control and Prevention states that, in its current assessment, “the immediate risk to the general public from H5N1 remains low.” The agency also said the risk was low when the virus swept the globe in birds and when it began circulating in dairy cattle across the country. Now, even with one confirmed and multiple possible cases, the message is still one of reassurance.
Some public health experts fear crying wolf when it comes to uncertain threats. This is a mistake. It would be a missed opportunity to resist honoring the public’s interest in remaining well in a bid to prevent alarm fatigue. Nor must all communications contain alarms. Simple, frequent, even “all quiet” updates have a place. Here, too, the weather community offers instructive examples. Even San Diego has weather reports, confirming that it will be 75 and sunny — again. Public health reports, news conferences and other engagements can similarly serve to gather information and reassure the public.
Deciding whether, when and how to communicate about public health risks is tricky. Outbreaks are fast-moving, complex and difficult to predict. The rise of misinformation and eroding trust in public health makes effective messaging even harder. No communication plan will be above reproach.
Still, this is a unique moment in history to shift public health’s approach to communication. Historically, one point of departure between weather and public health was personal experience. Most Floridians have lived through a hurricane, and most Nebraskans know tornadoes. But until the Covid-19 pandemic, few Americans had experienced a disease outbreak so widespread and severe. That has now changed, and more people are tuning in. The public health community must capitalize on this new awareness by embracing the public as partners in health preparedness and response.
Just as the weather community evolved to prioritize messaging, so too should public health. The job of public health experts is to give people clear guidance about what they will face and how they can protect themselves. That does not include a special mandate to prevent panic or stigma when doing so sacrifices clarity. The impulse to offer unfounded reassurance or conceal tough truths is a mistake — one that we need not make again.
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