Despite thousands of column inches, millions of social media mentions and the odd meme over the last year, Engine I MHP wanted to test the hypothesis that, actually, people were still in the dark on the science of COVID-19 and how this should affect their behaviour during lockdown.

To test the theory that there was a distinct gap between exposure, awareness and then understanding of key terms related to COVID-19 among the general public, we worked with Savanta ComRes to survey 2,000 members of the general public to assess which terms were known and which the public felt confident explaining to someone else.

The results were clear: across the 19 most media-cited terms tested (more on the number later), most people had heard of each terms, but far fewer felt confident in their meaning. Surprising given the consumptive effect of COVID-19 in the media since last February? Maybe. But the results have highlighted some distinct do’s and don’ts when feeding health messages to the general public, which are also applicable to the land of life sciences communication.

Let’s look at COVID first

While public recognition of both scientific (10 terms tested) and social terms (9 terms tested) was high across the board, the polling revealed variable confidence among the public in being able to confidently explain what these terms mean. Among the scientific terms most cited in the media since the pandemic began, ‘R number’ was recognised by 88% of the public, yet only 46% of those polled said they could confidently describe what an ‘R number’ is. Similarly, despite high (88%) levels of awareness, the term ‘variant’, could only be confidently explained by less than half of respondents (44%). Lowest ranking scientific terms included ‘asymptomatic’, ‘antigen’ and ‘PCR test’ with 16%, 26% and 35% respectively saying they had never heard of it.

Among more social terms tested, there was again high level of public recognition across the board, but a significant proportion of the public stated they couldn’t explain the following terms confidently, if at all: ‘support bubble’ (33%), ‘key worker’ (25%)  and ‘circuit breaker’ (40%).

The potential impact of these findings are of course wide-reaching. We know a significant proportion of the public get their heath information from peers and family members. The lack of confidence therefore among the public to explain what these critical terms mean, might contribute to the spread of misinformation. The exercise was also a stark reminder of how many new terms have been added to the public’s vocabulary since the pandemic began: we tested 19 of the most commonly-used terms, some of which having similar meanings. This should be a lesson in not only keeping the number of technical terms of a minimum, but also ensuring that there aren’t duplicative terms being cited.

Why are these findings important?

  1. Health inequalities and the prevention agenda: It can be said that information itself is a medicine. Having access to, and awareness of, the contributing factors to one’s health and wellbeing is a good place to start in leading a healthy life. Where information is lacking, or understanding or engagement in that information is low, is where health inequalities emerge and people are less well equipped to make informed decisions about their health. The experience of the pandemic has brought these uncomfortable truths into sharp relief. It is no surprise therefore that access to good quality health information is a building block of the dual agendas which are currently a focus for government, NHS and other healthcare actors beyond the immediate firefighting response to the virus: the prevention agenda and the health inequalities agenda.
  2. The empowered patient: Knowledge is power, not simply information.  There is an important role for the empowered patient in improving their own healthcare outcomes through their response to treatment and care.  As we found in our research the lack of pull through from recognising the new vocabulary of the pandemic versus really understanding the meaning of what is being communicated suggests that people are not empowered to advocate for themselves and those around them because information is not be translated into knowledge.
  3. Misinformation: In times of heightened uncertainty, people look for certainty and strong leaders. Where scientific experts have to couch their messages in careful, considered and caveated terms – purveyors of misinformation have no such concerns. When people are worried about their health, their families and their jobs, this makes fake news very potent. Information overload also makes the problem worse. When we are overwhelmed by information, we tend to look to “people like us” to help us make sense of the world. It is a mental shortcut, which people with malicious intent can exploit, by telling people what they want to hear. And the COVID-19 pandemic has produced an historically unprecedented amount of data and information for the public.

How should these data inform our work?

As healthcare communicators, we know that health information is important and should be taken seriously. The near-saturation of our television and social media screens during this past year with information about the novel coronavirus is proof of this. The gravity of health information and the importance to ‘get it right’ explains why we spend a huge amount of intellectual energy in the refinement and testing of our message, to seek that happy medium of clarity, simplicity and resonance. These efforts come to nought if they are not employed in the right way, by the right people however. In many ways, the messenger is as important as the message. In times of stress which, lets face it, includes a global pandemic, people look to people like them, their tribe, for comfort and reassurance. In times when our health is in jeopardy, we may receive information from expert healthcare professionals, but we will also seek validation from our peers. The trick, therefore, is to marry together messenger with message and ensure the spokesperson is able to truly speak to the people you are trying to reach.

What we do know for sure though is that we have learnt an inordinate amount about medicine, society and human behaviour during this pandemic. On the other side we’ll have a job on our hands to build a better, more informed and healthier world. A true understanding of our message, our audience and the messenger and knowing the consequences of getting it wrong will be a central part of that rebuilding job.

Kate Pogson is head of health at Engine I MHP