TRUTH AND CONSEQUENCES — The basic tenets of public health communication are to plan for the worst (although it's OK to hope for the best) and to always tell the truth — including clarity about what you don't know. That's true now amid the uncertainty of Omicron. It was true two years ago, when Covid-19 first emerged. And it was true a century ago during the 2018 flu pandemic; in fact, that's the main takeaway from John Barry's definitive book, "The Great Influenza." "Whether a politician saw an advantage and knowingly did something at best unproductive or whether he or she acted out of incompetence or fear, the human factor, the political leadership factor, is the weakness in any plan, in every plan," he wrote at the end of 460-plus pages. "Those in authority must retain the public's trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one," he concluded. But when the worst doesn't ensue, it can create a "Boy Who Cries Wolf" kind of phenomenon, making at least some segment of the population less likely to heed the warnings next time. (Shore-dwellers who dismiss hurricane evacuation warnings being Exhibit A.) And in our own societal moment of extreme partisanship, suspicion and distrust, what some of us may see as a "Thank God it wasn't so bad" moment, others see as yet another reason to lose confidence in expertise, in government, in science itself. They perceive themselves not as having been warned, but as having been lied to. So with Omicron's emergence in the U.S., how can the Biden administration practice those Golden Rules of pandemic communication without sowing even more division and distrust? "That's a problem — and that's a good question," Barry told me this week. The 1918 flu (known as the "Spanish" flu even though it probably began in rural Kansas) coincided with the U.S. mobilization for World War I. The mass movement of troops transported the virus across the country and across the globe. The lethal new version of the influenza virus would kill even more people than trench warfare and mustard gas did. The coronavirus emerged in China, at the early stage of a U.S. presidential campaign. Scientists confronting a virus called "novel" for a reason didn't quite know what it would do at first. As they gained insight they didn't always communicate crisply or consistently. For months, we coated the world with bleach and hand sanitizer when we should have been focusing on ventilation. Unlike its predecessor, the Biden administration never sugar-coated the danger, but it too had communication missteps, particularly around school openings and boosters. We have more tools against the coronavirus now: vaccines, new drugs, greater knowledge of the enemy. And science should have many more answers about Omicron within weeks — particularly about how well the vaccines will protect against it. In the meantime, public health communication should be built on what Barry called an infrastructure of uncertainty. "Explain from the beginning what you don't know," he told Nightly. "Create an infrastructure of what you don't know." If Omicron does turn out to be the worst case, or at least a very bad case, Barry wonders if it will mean the Covid deniers can no longer deny. Rallying the country around a war and underplaying the 1918 virus, as national leaders did then, was a devastatingly poor choice. But we can at least comprehend what they were thinking, even if they were appallingly wrong. The current politicization of vaccines, of masks, of the illness itself "continues to astound me," Barry said. Georges Benjamin, the executive director of the American Public Health Association, is a little more confident than Barry that the public can come to understand the nature of changing forecasts and science's moments of uncertainty. "At the end of the day — most people are rational," he said. "Tell them what you know. Tell them the information changed. "Some will believe you. Some won't. But people over time remember that you told them the truth." Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com. Or contact tonight's author on Twitter at @JoanneKenen.
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