When it comes to federal agencies communicating to the public about H5N1 bird flu, it feels like a classic case of Yogi Berra’s déjà vu all over again.
In the wake of pointed criticism about its failure to release new information about the growing H5N1 outbreak in livestock, the Animal and Plant Health Inspection Service of the U.S. Department of Agriculture (USDA) on April 21 — four weeks after the outbreak first hit the media — “data dumped” genetic information from cattle on its public database. The posted material further confused the public.
Two weeks later on May 1, USDA scientists published a preprint of a scientific paper based on this data, which has just muddled things further. While this report maintains that the spread of H5N1 to cattle is limited to a few herds, it also suggests that USDA sat on its data for more than a month and that the virus was mutating fairly rapidly in animals.
A comprehensive article in STAT on May 3 about the USDA’s latest H5N1 communications quotes a scientist with the Centers for Disease Control and Prevention saying that “the new findings did not raise any immediate red flags for increased risk to human health.”
The Food and Drug Administration, after maintaining a discreet silence on the subject of H5N1 bird flu, finally issued a public communication on April 24 reassuring the public that America’s supply of pasteurized milk was safe to consume and everything was OK — even though fragments of the H5N1 virus have been detected in milk. Yet a May 1 New York Times guest essay by Johns Hopkins researchers stated bluntly that dairy workers, most of whom do not speak English and many of whom are undocumented, are at high risk of infection.
A similar thread of ineffective and unhelpful communications emerged at the start of the Covid-19 pandemic in early 2020. Inconsistent and inadequate communication about the emerging threat diminished trust in government agencies and contributed to an overall poor response to the pandemic. But the USDA, CDC, and FDA seem to have forgotten the consequences of failing to admit any uncertainty in the face of a potentially high-risk pathogen. They have also failed to account for the threat of disinformation, in this case primarily from promoters of raw milk products, who are to pasteurization what Robert F. Kennedy, Jr. is to vaccines.
The same failures occurred two decades ago, when so-called mad-cow disease emerged and one of us strongly advised the government to be more forthcoming in reporting the status of surveillance and the most current estimated threat level to human beings.
As health communication specialists, we think that the federal government is once again failing to follow best practices when it comes to communicating transparently about an uncertain, potentially high-risk situation. To be sure, the government needs to improve its capability to manage an array of other urgent issues surrounding H5N1, including surprisingly inadequate surveillance, limited testing capacity, and a dangerous lack of access to health care in the rural regions that are most likely to be initially affected if H5N1 spills over into humans. But failure to communicate systematically in the present environment is an equally urgent challenge.
During a crisis, government communications are often cited as one of the key factors in successful emergency response. Compassion, correctness, and credibility are central. Compassion: government communications must empathize with what people are experiencing, including the sacrifices many of them must make. Correctness: communication should always be up front and transparent. Credibility: the flow of information should be consistent and reliable.
When government agencies communicate during a crisis, they often focus almost exclusively on what to communicate. We believe there needs to be equal emphasis on when and how to communicate. Public response to the H5N1 situation suggests that people are dismayed at what appears to be almost random announcements with unexplained silence in between. That’s a problem because plenty of third-party disinformation fills those gaps.
To establish consistent, trustworthy, and reliable communication, government agencies need to lay out when they will communicate about H5N1, explain when they will not, and stick to the plan. We offer three suggestions to help them do this:
Create a comprehensive intragovernmental communication plan based on multiple scenarios. It’s abundantly clear that no one knows for sure where bird flu is heading: Will it be confined to cattle, or will it spread to other species, including humans? Government agencies need to be prepared to communicate thoroughly and consistently, and plans for several scenarios should be laid out in detail now.
Make public the government’s planned strategy for H5N1 communication. Government agencies should provide people with a rough schedule of when they should expect to be updated. This will build trust and confidence in government actors. If an update is not available at one of the planned times, spokespersons should be prepared to say so and to explain why. The worst possible scenario is to appear inconsistent and unpredictable.
Coordinate communication across agencies on a daily basis, emphasizing trustworthy, quality information. Few Americans know the jurisdiction of various agencies. Milk comes from cows, so is the Food and Drug Administration in charge or the U.S. Department of Agriculture? Make it clear from the beginning who is doing what and who will be communicating on what aspect of the response. In the case of H5N1 bird flu, the USDA, FDA, and CDC should establish a joint H5N1 communication team and engage other credible stakeholders — including industry scientists, employers, retailers, the media, and others —so information is presented consistently and understandably to audiences of all types. Appointing a single highly competent and credible spokesperson, such as Surgeon General C. Everett Koop was during the first years of the HIV/AIDS crisis, might make sense.
Communication is not an afterthought. It is absolutely central to emergency response and can be a deciding factor in maintaining control over the effects of an outbreak.
Sara Gorman, Ph.D., is CEO of Critica and author of the forthcoming book “The Anatomy of Deception: Conspiracy Theories, Distrust, and Public Health in America” (Oxford University Press, 2024). Scott C. Ratzan, M.D., is the founding editor of the Journal of Health Communication, distinguished lecturer at CUNY Graduate School of Public Health and Health Policy, and author of “Mad Cow Crisis: Health and the Public Good” (NYU Press, 1998). Kenneth H. Rabin, Ph.D., is a senior scholar at the City University of New York Graduate School of Public Health and Health Policy and a co-author of “Informing the People: A Public Affairs Handbook” (Longmans, 1981). All three are founding members of the Council for Quality Health Communication.