Nicholas Kadysh: Public health is killing us with communication

Public health’s bad habits have metastasized unchecked — and they are destroying goodwill with the population.

By: Nicholas Kadysh

Public health is a unique domain of the medical profession. It’s undeniably difficult at the best of times: this field not only attempts to ward off disease, malnutrition, and the unnumbered outside dangers that the world presents to a population, but also to encourage people to make good choices. To put down the cigarette or the liquor bottle, to exercise more, to eat better. To do this work during a pandemic ratchets up the stakes, and the challenges, a millionfold.

It is for this reason that a public-health education usually includes communications training, because getting heard is hard — especially when the message is as dull and predictable as telling people to work out or wash their hands. The answer: spice it up.

Will announcing to the world that eating meat causes cancer get some headlines? Undeniably — even if the increased risk is fairly low. Will stirring up a panic about children drinking energy drinks get you in the news? If your mission is pure enough — like getting people to drink less alcohol — you may even be tempted to exaggerate a statistic, like saying that alcohol is responsible for 38 per cent of all health-care costs in Canada, rather than just 38 per cent of substance-use related health-care costs. It’s not like anyone’s going to check.

Ultimately, all of this amounts to the same thing: motivated reasoning. Ends justifying means. Nobody denies that people begin working in public health to help others; God knows, nobody is doing it for the pay. But here and now, in 2021, public health’s bad communications habits have metastasized unchecked — and they are absolutely destroying goodwill with the population.

I’m not just speaking about the greatest hits of 2020, like: “Masks won’t help contain transmission, which is why it’s crucial we save them for frontline health-care workers.” Right now, today, public-health leaders across the country are sending messages with breathtaking amounts of cognitive dissonance.

How can Variants of Concern (VOCs) present such a significant risk to younger people that it is landing them in hospital ICUs in droves, necessitating further lockdowns, while the National Advisory Committee on Vaccinations determines that the risk from the AstraZeneca vaccine to those same individuals is higher than the virus itself?

Why do governments across Canada maintain that we can't lift any restrictions even once significant portions of the population have received their first dose, while simultaneously telegraphing that rapid single-dose vaccination is the only way to blunt the third wave currently washing over B.C., Alberta and Ontario? Either a single dose is enough to reduce COVID transmission and infection, or it isn’t — and future restrictions must flow from that reality.

Lest you think I’m picking unfairly on Canadian public-health practitioners, it’s worth noting that the problem of bad communication is not a unique phenomenon along national lines. Worries about viral mutation or breakthrough infection are germane — but not when they are presented as a blanket edict for vaccinated people not to eat indoors or gather in groups.

In all of these instances, there is simply no way to square the circle in a way that makes sense to regular people — and regular people are the target audience.

Does the AstraZeneca vaccine present more risk to young people than COVID variants? Highly unlikely. Will some restrictions get lifted at some point in the next few months, as our vaccination rates rise and death rates fall? Of course, and hearing public-health officials claim the opposite with a straight face — as the U.K. vaccinates millions with the AZ vaccine (with few adverse effects) or as the CDC authorizes vaccinated Americans to both gather and travel — will lead to only one outcome: Canadians concluding that our public-health officials are full of crap, and disregarding future advice.

In all of these cases, the motivated reasoning for the bad communication approach is the same: people can’t be trusted with the truth. If there’s a run on masks, doctors won’t have any. If vaccinated people hear that restrictions are going to be lifted soon, they may go out and party today. But public-health leaders are no longer on the sidelines — in many very real and important ways they actually run this country at this moment in time. There is simply no excuse for disingenuous communications to the public — or treating people like children. It isn’t just a bad look. It is actively harming the goal of public health.

Nicholas Kadysh is the CEO of PharmAla Biotech.

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