OTTAWA -- As Canadians grow more tired of the restrictions the nearly eight-month long pandemic has imposed on their lives, experts in health policy say so too has their frustration with the communication around those directives.
David Fisman, a professor of epidemiology at the University of Toronto鈥檚 Dalla Lana School of Public Health, says conflicting medical guidance in recent months has left room for public doubt.
"The difficulty is, there have been so many backtracks, about-faces, and you know mixed messages," he told CTVNews.ca via phone on Tuesday. "What are people supposed to make of this? It鈥檚 just not coherent."
The most recent example of this was the flip-flopping guidance on how to safely celebrate Thanksgiving in Ontario. Confusion mounted when in the same week, the province鈥檚 associate medical officer of health ruled out celebrations with people outside one鈥檚 household, but then a few days later Premier Doug Ford said he鈥檇 be gathering with up to 10 people.
At the same time, officials said restaurants and workout facilities weren鈥檛 the major source of transmission, only to announce a few days later that indoor dining and gyms would be closed.
Now, on the eve of Halloween, we鈥檙e seeing similar contradictory advice. At one point, it looked promising that all corners of the province could go door-to-door collecting candy, but slowly, as cases climbed, certain hotspots have been told to stay home.
This goes against the advice of Canada鈥檚 Chief Public Health Officer Dr. Theresa Tam, who says she doesn鈥檛 see trick-or-treating as risky. Neither does 愛污传媒 Infectious Disease Specialist Dr. Abdu Sharkawy.
"Let鈥檚 remember that this is one of the few occasions that can almost exclusively be experienced in an outdoor setting. We know from the science of transmission of this virus that the risk is incurred by being indoors in poorly ventilated areas, areas in close contact with others for prolonged period of times. I struggle to think how this is something we need to worry about," Sharkawy said on 愛污传媒 Channel on Tuesday.
Fisman says unless officials can show there is some evolving science that proves trick-or-treating outdoors is unsafe, it鈥檚 bound to cause anger and confusion.
"It comes down to understanding the science and then articulating that to folks who don鈥檛 necessarily have that background, or spend their lives studying communicable disease. You have to be able to talk to people and motivate them in a way that resonates and puts them on the team," he said.
He points to B.C.鈥檚 provincial health officer, Dr. Bonnie Henry, as an example of an official doing it right.
"[She] can talk to people in plain language and say look, you know, this is what we鈥檙e doing, this is why we鈥檙e doing it, this is why we have to do it, here鈥檚 the end game, here鈥檚 what鈥檚 in it for you and for all of us," said Fisman.
The U.S. Centers for Disease Control and Prevention outlines seven steps to effective messaging amid an outbreak: Start with empathy, identify and explain the public health threat, explain what is currently known and unknown, explain what public health actions are being taken and why, share dilemmas, foreshadow possibilities, and emphasize a commitment to the situation.
Fisman says some of those steps aren't being met in Ontario.
"I鈥檝e felt for a number of months now, we just don鈥檛 have anyone kind of steering the ship who has the ability to communicate."
It鈥檚 not because officials have gotten worse at pandemic messaging, he said, but more so because the public has become more informed and thus less passive when regulations arrive at their doorstep without justification.
"You have this broad swath of the population that actually understands a pandemic in quite a sophisticated way. I think it鈥檚 becoming a problem, this isn鈥檛 armchair epidemiology anymore," he said. "It has to make sense in a connected world where people have access to a lot of information."
Timothy Caulfield, a professor of law at the University of Alberta and Canada Research Chair in Health Law and Policy, says skepticism is bound to rise when medical directives shift to reflect new evidence.
"[Public health authorities] are struggling with a lot of scientific uncertainty. They have to struggle with the context of local conditions being different and that can result in a variation in recommendation from jurisdiction to jurisdiction and that can also result in public health authorities changing their minds as we鈥檝e seen with masks," he said.
Caulfield says it鈥檚 up to public health and politicians to be more transparent and frank when information is still unknown to prevent a reversal in positioning.
"It鈥檚 a mistake to be dogmatic in your recommendations when you know that the evidence base is less than robust and we鈥檝e seen that at times and we still see it," he said. "They鈥檝e had to revisit their language and I think that鈥檚 really problematic."
He says as confusion mounts, the public will often look to alternative, and at times untrusted, sources of information to satisfy personal opinions.
"When you鈥檙e frustrated and perhaps have a particular ideological leaning, you are more likely to gravitate to a narrative that fits your personal brand and that鈥檚 definitely happening now, you鈥檙e seeing that more and more," he said.
Caulfield and Fisman agree the trajectory of the next phase of the pandemic will hinge on strong communication.
"Good communication is every bit as important as a functioning microbiology lab in terms of controlling a pandemic. It鈥檚 a key, core, component of this effort. How are you going to motivate people if they don鈥檛 find you credible and they don鈥檛 like you because you鈥檙e shaming them?" said Fisman.
