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Public health vs. pandemic fatigue: The COVID messaging conundrum

C/O Spectrum Health

When we first realized COVID would be the biggest public health crisis of our lifetime, Governor Gretchen Whitmer came out swinging. She set up mask mandates and physical distancing recommendations. That earned her respect from many public health officials both within Michigan and around the country. 

But the governor’s message now is very different. So, what changed?

“It is a constant tension in public health of how much to try and legislate versus rely on people's good judgment and free choice,” explained Kenneth Resnicow, professor of health behavior and health education at the University of Michigan. Resnicow is the chief scientific lead at the University's Center for Health Communications Research. We spoke with him about the evolution of public health messaging throughout the pandemic. 

Whitmer’s initial messaging about COVID-19 was clear and consistent 

“Michigan, in particular, was clear and unwavering about the initial behavioral steps of masking, social distancing, and other protective behaviors. So I think the governor and her team from the get-go set out very clear objectives. Whereas nationally and in other states, I think there was more mushiness to the recommendations, which I think ultimately hurts their credibility and their uptake. So I think, in general, Michigan was a leader in clarity around protection and more recently, vaccination.”

There are still some public health orders in effect. But Whitmer has declined to tighten those restrictions even as Michigan cases reached record highs. Instead, she turned her focus to the push for Michiganders to get vaccinated. The governor recently announced that once 70% of Michiganders receive their first vaccine dose, the state will rescind the health department’s face mask and gathering orders. 

In the meantime, she’s relaxed some restrictions as more people have gotten their shot. This week, Whitmer announced that masks are no longer required for outdoor gatherings of 100 people or less. 

Who is hesitant to get the vaccine?

“The data is very clear that in the vaccine-hesitant group, there's really two audience segments. There's the ‘wait-and-see’ group. And then there's the, what we call, the ‘hard no.’ We have currently mostly ‘hard-nos’ remaining. A lot of the ‘wait-and-see’ folks have had their time on the bench waiting, and now they're ready. The ‘hard-no’ group is particularly sensitive to freedom issues, that when you ask them what are they worried about, being controlled or feeling their freedoms are being threatened are in their top one or two reasons why they're hesitant.”

Times when public health experts were challenged by politicians

“When Michelle Obama came out with her, physical activity and diet program, the right...went after Michelle Obama for being a nanny stater, for not trusting the American people, for legislating free choice and legislating common sense; so this has happened before. Motorcycle helmets has raised this as well. Gun rights sometimes also raises this issue. So I think this [COVID-19] is perhaps the most salient example of our time. But in public health, we have been accused of being nanny staters for many years; of not trusting people's good judgment. And it's a very complicated issue because if we simply let people follow their impulses, sometimes they might make risky choices that endanger other people.”

What Resnicow has learned about public health messaging during the pandemic 

“There's this philosophical, ideological pushback against something that many Americans said shouldn't be political, but the fact that such a relatively apolitical behavior has become so politicized and connected to religion and ideology is really unique in our lifetime and has really challenged our ability to come up with messages and interventions. Particularly for this tail end of the beast, this highly resistant group, we haven't done enough to motivate them yet.”

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