Independent report

Chapter 11: communications

Updated 10 January 2023

During a national medical or public health emergency, the public as well as decision-makers want to hear from clinicians, scientists and public health experts, among them CMOs and GCSA. We will leave in-depth analysis on communications to experts in the field but as it was such a significant part of the pandemic, we set out here some of our reflections for future CMOs or GCSA.

Communicating with the public

There was regular engagement with the communications teams in the health departments and public health agencies across the UK, which had a central role in communicating with the public. There was, at least initially, an almost limitless demand for authoritative medical and scientific information. The media medics, and most specialist health and science correspondents, provided challenge, were well informed and generally relayed accurate technical messages clearly.

Communications took various forms:

• written statements
• press conferences on background and live to camera
• television, radio and social media adverts
• live and pre-recorded interviews with journalists
• question and answer sessions with the public

As CMO or GCSA, many people legitimately want to know your advice on medicine, public health and science, and less constructively answers to questions which are political. Consistently staying in our area of expertise (science and medicine) was important. There was genuine public concern and speaking directly to the public on medical and scientific matters was vital, especially being clear on what was known, the degree of confidence, the balance of risks and just as importantly what was simply not known at different stages.

Many members of the public will not seek information from or know what a CMO or GCSA is. They will use other channels or trusted messengers. It is important that all communities receive accurate information in an accessible way, in the language they speak and through the channels and messengers they trust.

The appetite for data (cases, hospitalisations, deaths) and latest scientific evidence (what is known about transmission, the disease, likely health outcomes and evidence-based ways to reduce risk) was constant. This was most challenging at the outset of the pandemic when reliable information was limited and data flows and visualisations were basic.

Over time, a sophisticated set of timely, accurate data visualisations and easily available summaries (such as the highly successful COVID-19 Dashboard) were developed and curated, which helped fill this need with reliable data. These were used for ministerial briefings and press conferences. We would recommend something similar is developed in a future pandemic.

Transparency

People and Parliament will want, and reasonably expect, to know the science behind advice. It is important this is available and presented in a transparent way. Communicating epidemiological principles was central to helping people understand the reasons for advice, especially early in the pandemic.

Media briefings, Parliamentary scrutiny committees, publication of Scientific Advisory Group for Emergencies (SAGE) minutes, open access to medical journals and publicly available summaries of latest evidence from academic experts all supported informed dialogue. Having all SAGE papers and minutes available to the public was a major advance.

It was important to be clear and open about uncertainties and unknowns throughout as the evidence base, and our understanding of the situation, evolved. Routine summaries for professionals, the public and decision-makers of what is known and unknown will be needed in the future too.

Addressing misunderstandings

Particularly in the early stages and with vaccinations, we found that disinformation and misinformation were issues, especially with social media use at scale unlike previous pandemics. This is likely to be the norm from now on, and gives an equal voice to the highly informed, uninformed and malicious. There is a major difference between people with genuine and legitimate concerns (for example, about vaccines) and those with other agendas. Therefore it is important that sensible, well informed professional colleagues put out information and engage in courteous debate. Scientists and their teams will also be communicating with the media as well as directly to the public in order to correct inaccuracies.

Widespread publication of pre-print research without full peer review presented challenges. Media outlets and journalists in the vast majority of cases made a real effort to understand the science and to communicate this clearly. Inevitably, there were some points at which media translation of the science was not accurate, and in these cases it was important to reiterate the scientific advice.

The work of dedicated journalists and organisations like the Science Media Centre, which sourced high-quality scientific commentary, helped interpret research, put it in context, explain limitations and in doing so support informed debate while being clear where scientific consensus lay. Sometimes independent scientists had strong views on policy choices. Informed debate is important, but the blurring of science advice and policy opinion could cause confusion.

Misunderstandings are a particular risk where new evidence is rapidly coming to light and there is a desire to know more at pace. In particular, the outputs of statistical models were sometimes misunderstood. It is important to be clear about the limitations of modelling and the nuances and assumptions behind model outputs when they are presented, but this is not easy.

Communicating with professionals

During this pandemic, it was extremely helpful to communicate regularly and in both directions with clinical and public health colleagues – for example, through weekly calls with the Academy of Medical Royal Colleges (the presidents or chairs of the medical royal colleges and faculties) or with directors of public health. The learned academies were an important additional source of information.

This helped us better understand the situation our colleagues were facing across the country, hear constructive challenge, and gave us a forum to discuss the latest data, scientific advice or explain the background to policy changes. As travel was difficult or impossible during lockdowns this was even more important as we were unable to conduct visits.