The Centers for Disease Control and Prevention has been the target of criticism in recent weeks, due to a series of mixed messages and contradictory guideline updates around the ongoing COVID-19 crisis. Not surprisingly, public health experts have called on the agency to improve its communications strategy, pointing out the recent whiplash over changing mask guidance as well as confusing information following a COVID-19 outbreak in Provincetown, Massachusetts.

While the agency is renowned for its sound science, its communications have come under the microscope over the course of the last 18 months. Which isn’t to say that it isn’t trying: 

The CDC has devoted a section of its website, “Trainings, Tools and Templates,” to communication-related issues. It includes a fairly robust trove of advice around social media, mobile apps and writing.

But the agency’s current communication issues go far beyond how the agency uses social media. Healthcare communicators admit that altering the CDC’s approach would be a complicated and challenging assignment even in a non-emergency situation. At the same time, just such a change will be necessary in the months ahead as the U.S. battles Delta-fueled surges and races against the clock to get a greater percentage of the population vaccinated.

“One of the key things, particularly when we think about communications in the context of the pandemic or any real kind of public health emergency, is the importance of transparency and trust,” said Trey Watkins, EVP of global health and corporate responsibility at GCI Health. “Without those two pillars, we probably fuel a cycle of confusion and mistrust.”

Watkins noted that the CDC has done a solid job of ensuring that its guidelines and associated communications are grounded in science. The problem with this? What we know about the science has been changing on a near-daily basis since the start of the pandemic.

Thus it will be integral for the agency and other public health officials to convey that science to the public in a more streamlined and readily comprehensible manner.

“While being grounded in science, epidemiology and public health, we have to make sure that, through our communications, it’s all understandable,” Watkins explained. “Not everyone is a public health expert, a scientist or medical professional. It’s a talent and a skill and an art to make health information relatable, approachable and understandable to the layperson.”

Watkins pointed out that the current intersection of science and policy – not to mention overarching political considerations – makes the jobs of CDC communicators incredibly complicated. As a result, they may choose to focus on how information trickles down from the CDC to local communities.

“We have a layer of politics over this that we can’t remove from the equation,” Watkins said. “What we’re seeing is a lack of a systemic approach – a lack of a standardized approach to masks and vaccines as cities go back into lockdown, and as some cities reinstate mask mandates and others don’t.”

He’s referencing the recent confusion over the CDC’s revised mask guidelines, which led states, local governments and individual businesses to interpret the information as best they could. In May, the CDC said vaccinated people didn’t need to wear masks in indoor settings. Now the agency is advising vaccinated people to wear masks in areas of high spread.

Watkins believes the CDC needs to develop a more streamlined way of communicating guideline updates, ideally through hyper-local channels and community leaders.

“From a global public health perspective, we’ve always found that the person delivering that message matters,” Watkins said. “The language that we are using matters. It’s important to not only lean on [CDC leader] Dr. Walensky’s daily briefings, but also to ask how that [information] trickles down into communities in a way that’s transparent and trustworthy and relatable.”

Similarly, the CDC needs to prioritize the information it shares. Watkins argued that breakthrough infections among vaccinated people, while important to track, shouldn’t be a primary focus of CDC communications.

“From a communications perspective, we have to keep our attention on the power of vaccines and meeting those vaccine-hesitant communities,” he continued. “From a public health perspective, the vaccine is the only way out of this. But we have to ensure trust in it and we have to ensure access to it.”

That means continuing the hyper-local work of attempting to make believers out of the vaccine-hesitant.

“Here we are in this intersectionality of public health, community advocacy and policy, when we’re thinking about public health need and burden, community needs and demands,” Watkins said. “Communications is woven across all of that somewhere. It comes down to how we are engaging in communities and elevating community voices.”