Confusion has reigned during the coronavirus pandemic.
Comprehension of what is and isn’t permissible has grown more challenging as regions teeter between reopening and reclosing amid surging coronavirus cases. There are Thanksgiving recommendations to sift through, Halloween guidelines to review, and selective closures to keep up on.
While it’s somewhat symptomatic of the still-evolving science behind the virus, making sure the changing messaging is delivered and received correctly “doesn’t seem to be the priority it should,” said Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa.
“Public health communication is not as simple as putting out some tweets and press releases,” he said.
“It’s a complicated, nuanced endeavour that involves building relationships and trust and authenticity as well as fragility. Somehow we’re acting out of the political playbook of projecting a position, more so than enabling a relationship in communication.”
Spring lockdown to fall holidays
When the coronavirus shutdown was ordered in March, the message was simple: stay at home and don’t leave the house except to shop at essential businesses or perform essential work. Despite being hard to swallow, the instructions were clear.
Fast forward four months and businesses started to reopen. That’s where mixed messages started to trickle down from every level of government, making it difficult to decipher what’s allowed and whether that applies to you.
And it’s only gotten more muddled, according to Deonandan.
The “hammer and dance” phase, as described by Canadian infectious disease experts, has made keeping up with rapidly changing rules and restrictions difficult. As policymakers balance controlling the virus with reopening economies, what a person can do now varies by province, region and, in some cases, specific communities or “zones.”
Often times, it can appear completely out of sync. October has been a stark example of this.
First, there was Thanksgiving.
Canada’s Chief Public Health Officer Theresa Tam advised Canadians — particularly those in hard-hit Ontario and Quebec — to “keep to your immediate social circles” for the holiday. However, social circles hadn’t been in place in Ontario since Oct. 2, and some regions in Quebec had already banned visitors between households.
Asked whether he would visit extended family on Thanksgiving, Premier Doug Ford said he would only see 10 people, but later clarified on Twitter that he would only gather with those in his household.
One day later, he acknowledged that messaging isn’t “as clear as it should be” and that “we all need to do a better job — even myself included.”
Deonandan agrees. While there’s “no perfect solution,” he said risks need to be better defined when governments roll out, or rollback, directives.
“I think we have to show our work. Show how we define risk. That, based upon these metrics, we feel these activities are low risk, these are high risk, and this is how we would modify these activities,” he said.
“We’re missing that right now.”
Recently, the sticking points in communication have centered around Halloween. Tam and her counterpart said there’s no need to cancel the tradition, so long as trick-or-treaters respect the new realities of the pandemic.
Most provinces agreed, but others did not. In New Brunswick, what you can do on Halloween depends on the region you live in. In Ontario, kids in COVID-19 hotspots are being encouraged to not go trick-or-treating.
The conflicting standpoints were picked apart online, where backlash was swift. One tweet summed it up as: “Not confusing at all!”
“This is a place where the federal government shouldn’t be piping up about this. This is an entirely local decision — what does your community tolerate?” said Deonandan.
“We have to be as transparent as possible, especially about what we don’t know. We need to explain that because we don’t know, we’re going to err on the side of precaution to keep you safe.”
But that is the inherent challenge, according to Cynthia Carr, a Winnipeg-based epidemiologist.
The community-based spread is not the same everywhere, she said, so what feels like inconsistency may just be an attempt by governments “to find a way to live to the virus and react where necessary.”
“It’s weighing harm reduction and coming up with strategic approaches,” she said.
“It’s difficult with ongoing changes to always get the messaging exactly correct. The best way is to outline what we know, what we’re doing, why, and what you need to do. If that was always the structure of public health messaging, people might understand better.”
In Ontario, the latest source of confusion is tied to dance studios.
Studios in parts of Ontario designated coronavirus hotspots can reopen their doors with some restrictions, including sticking to indoor gathering rules by allowing no more than 10 people inside at once.
But, just two weeks prior, health officials shuttered indoor fitness activities in these regions due to the risks of indoor transmission, where distance is harder to maintain and masks difficult to keep on.
The province’s move was said to bring dance studios in line with activities like swimming and other sports, which are still allowed to continue during the new restrictions.
It set another dose of “confusing messaging” rhetoric in motion online.
Deonandan sees some of Ontario’s rationale. Dance studios can be akin to schools, where the same number of people are in the class each time, he said, so the number of exposures is “constant.” Plus, if it’s not a high-exertion situation — “just the fundamentals” — then there’s a lower level of exhalation, which the virus can spread more easily.
“The confusing part is, is dance exercise? And if it’s exercise, then why is it not categorized as a gym?” he said.
“It’s better to categorize them by the nature of the risk, rather than the nature of the activity. These decisions are based on the size of the venue, the intensity of the activity, the number of exposures per event, the rate of cases in your community, et cetera, et cetera.”
In other words, people need governments to “show your work,” he said, that’s what was missing in announcing the decision.
The provincial government clarified to Global News in an email that fitness settings, unlike dance studios, are done on a “drop-in/one-time/episodic basis,” which makes contact tracing more difficult and exposures higher. Since dance classes “effectively cohort” participants, “the fundamentals and techniques… can be delivered safely when public health measures are followed.”
Ford said Wednesday the province will be reviewing fitness studios, as well.
But Carr said the decision still needs more clarity for the general public.
“We know now the high-risk situations. Indoor spaces, recirculated air, not wearing a mask, exercise, or exertion. Dance studios appear to meet those criteria,” she said.
“It’s challenging for public health to react in real-time, both in making those decisions and communicating those. We’re seeing that here.”
What needs to improve?
Now that the pandemic is unfolding differently in different places, federal and provincial authorities should “defer to local public health leaders whenever possible,” said Deonandan.
There also needs to be more clarity on the data and metrics driving these decisions, he said.
Officials guiding Canadians through this pandemic need to realize that without transparency, there is an increased risk of “disenfranchising a paranoid population,” which risks bolstering misinformation and distrust for authority, he said.
“We have to be as transparent as possible, especially about what we don’t know, so people don’t accuse us of hiding things,” he said.
“We need to explain that because we don’t know, we’re going to err on the side of precaution to keep you safe.”
— with files from the Canadian Press