Why did we lose trust during the pandemic?
My conversation with Kelley Krohnert
I am very concerned about declining trust in science and public health. Although there have been many polls and much talk at conferences, one big thing has been missing: listening to people whose trust we are losing.
This has been really hard for me to approach. I’ve been in the trenches for the past four years, so it’s personal, still very raw, and the bruises still feel fresh. When am I ready to listen? Who is genuinely interested in giving constructive feedback without it turning into a finger pointing match?
Well, I didn’t have to look around to find the answer. Kelley Krohnert reached out to me. I was familiar with her, as she was a strong voice on social media throughout the pandemic. Although we have a lot in common (both moms, in the South at the time, both data-driven), we disagreed loudly. It took me a few days to decide whether I was ready to respond. But I eventually accepted her invitation, and we met on Zoom. Much to my surprise, it was a constructive, respectful discussion. Some of it was hard to hear. Some of it I wasn’t surprised to hear. And, we still disagree on a lot, but I am genuinely glad we had this discussion.
We didn’t record the conversation, but I asked if she could summarize her points below. Why did we lose trust during the pandemic?
Take it away, Kelley…
Everything sounds like a sales pitch
From Paxlovid to vaccines to masks to ventilation. Public health sounded (and still sounds like) a used car salesman for many different reasons:
Data seems crafted to feed the pitch rather than the pitch crafted by data. Overly optimistic claims weren’t well-supported by data, risks of Covid were communicated uniformly which meant the risks to young people were exaggerated, and potential vaccine harms were dismissed. Later, when it was time to pitch boosters, public health pivoted on a dime to tell us vaccine protection wanes quickly. How did we get here?
Data mistakes. For example, when CDC claimed Covid was a top 5 leading cause of death in children based on flawed data. How can people give public health the benefit of the doubt when such obvious data mistakes were made?
Messaging inaccuracies. Messaging was so poorly worded that it caused people to misunderstand and start their conspiracies. For example, recommendations to get the bivalent booster 2 months after your last dose led many people to think that boosters were being recommended every 2 months.
Mixing advocacy with scientific communication. Many people pretend to be unbiased scientists or journalists, but instead only share studies that support their claims and attack any other perspectives that don’t meet their interpretations or values. The latest example was a long Covid discussion at a recent congressional hearing, and one of the top long Covid doctors saying, “The burden of disease from long Covid is on par with the burden of cancer and heart disease.” There was also a flyer handed out with some statistics taken out of context. (Other scientists have since refuted it.) It’s sometimes hard for people to know who is a straight shooter and who is an activist.
Information that would have been helpful was never provided
I could never find a basic guide for people about how to take care of themselves, their children, or their parents with a mild/moderate case of Covid. Practical, helpful, and simple recommendations like: Does staying hydrated help? Should I use over-the-counter fever reducers as needed? What are signs to watch out for? NPIs and vaccines were pushed to prevent Covid, but that didn’t help already sick people stay out of the hospital.
I also expected more investigation into children and young people who experienced severe Covid-19. Covid-19 has a huge age gradient, with kids least affected—but some kids were affected, and parents never heard what specific risk factors were the biggest concerns. Instead, all risk factors were treated equally, which meant that people at high risk didn’t realize it, and those at lower risk were overly fearful.
Everything is misinformation, so nothing is misinformation
Many opinions were treated as undeniable facts, and anything that went against that was dubbed misinformation, when they were often just a different reading of the evidence or a different value judgment based on the evidence. Many things were not as black and white as claimed. People sharing legitimate harms of school closures or post-vax myocarditis risks were all deemed to be promoting “misinformation.” Like the boy who cried wolf, this makes it hard for public health to be trusted when countering verifiably false claims.
A disconnect between what I experienced on the ground and the narrative I was hearing
While some people did get very sick from Covid, and many doctors were indeed traumatized by this, many people knew few, if any, people who were hospitalized or died from Covid. While hospitals were dealing with the worst cases, a lot of the Americans weren’t affected in the same way. People were sick for a week or two and recovered, and subsequent infections were typically uneventful. Messaging from CDC like the recent tweet claiming “your next infection could be your worst” just isn’t credible for people who experienced a fairly ordinary illness from Covid.
Some things are improving
I have started seeing some change, which is why I reached out to Katelyn in the first place:
For example, the CDC now has a blog with more plain language and is responsive to the conversations on the ground. The latest entries are refreshing to read. For example, this one where they properly contextualized the burden of Covid this past winter.
Also, the updated guidance on Covid isolation catches up to where much of the world has been for a while now.
Bottom line
From Kelley: I’m glad Katelyn was willing to speak with me. I’ve been trying to reach out to those who I often butted heads with about Covid, and try to build bridges, because I think it’s important to help public health understand the perspective of many of us who lost trust during Covid. We don’t have to agree on everything to have a respectful conversation.
From Katelyn: I was toying with whether I should insert my opinions throughout this post, but in the end, I wanted to listen. I admit—I made some of the mistakes above and her points reflect some of the lessons I’ve learned. But I also know that public health poured their heart and soul into the emergency. I hope we can bring the lessons learned forward— both positive and negative. In fact, I would argue, we have no other choice.
Love, YLE
P.S. I had many thoughts, reactions, and opinions during and after this conversation. I’m sure you do too. Please be respectful in the comments to help facilitate hard but important conversations.
“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, M.P.H. Ph.D.—an epidemiologist, wife, and mom of two little girls. During the day, she is a senior scientific consultant to several organizations, including CDC. At night, she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below:
Many Americans seem to think that total knowledge of COVID-19 arrived on Day One, and thus all advice should have been perfect from then on. That's not how life works.
I'm in awe of the CDC and scientists in general and tend to attribute their factual errors to the fact (obvious only to me??) that they began, as we did, with no solid knowledge about how COVID spreads, or precisely how masks, social distancing, and vaccines protect us.
Though all info was imperfect, strong messages were immediately (and perpetually) needed to counteract anti-vaxxer lies that were being promoted by the then-President, of all people. Those lies were killing thousands of Americans day after day from Day One and continue to do so.
My own inclination has been to stay alive, not to argue. When advice changed, I adjusted my safety procedures. One day, I stopped washing groceries and patting the mail with disinfectant wipes. I first bought surgical masks then set them aside and bought the more protective kind. When advice in the media was puzzling or self-contradictory, I studied YLE and Johns Hopkins emails.
This old lady just got vaccinated for the #?th time and will keep getting boosted as often as possible. I suspect that some people are just querulous by nature, and never glimpse the big picture.
It seems the big ELEPHANT in the room is being ignored. When leaders, as in the president of the USA and Governors like mine in Florida, tell people during an active pandemic, "just ignore it, it will go away", and then State Surgeon Generals like mine in FLA tell people vaccinations are dangerous and could harm you, that creates serious disbelief in science. People seek direction from leaders. It is very hard for those that are part of the current cult that follow a flawed narcissistic leader to overcome their emotional brain and think with their executive functioning side of their brain. I know many people at the doctorate level that have suddenly become anti vaccine because of political pressure. It is so hard to comprehend that change in the face of data, yet your statistics bear that out.