Transcript - Communicating Evidence in a Pandemic

The public appetite for scientific evidence during the pandemic has been voracious. But communicating it well is a fiendish balancing act. How can governments give clear advice while also acknowledging uncertainty? How can scientists debate complex evidence while supporting strong interventions? And how can the media scrutinise public health measures without undermining them? Joining David to navigate the principles and pitfalls of communicating evidence in a pandemic are: Victoria Macdonald, Health and Social Care Editor for C4 News Tracey Brown OBE, Director of Sense About Science Professor Christina Pagel, Operational Research at UCL and member of Independent SAGE   ***   David: Communicating science and evidence in a public health crisis like the current pandemic raises a huge number of really tricky ethical issues. We want the media to share crucial public health guidance, while also criticising that same guidance where necessary and holding the policymakers to account. Can we have it both ways?  And what about governments - they want to communicate clear and simple health advice - but how much should they acknowledge the sometimes complex and uncertain evidence behind some of that advice? And finally for scientists and academics: should they publicly challenge evidence, or does that risk undermining measures intended to keep us safe? It’s a minefield, as many of us have been discovering, and everyone has been having to find their own way through. But what can we learn from the last 6 months to help us go forward into the next 6, and other public health crises to come? I've got a brilliant panel of guests with me who've all been in the thick of things in different ways. Victoria McDonald is the Health and Social Care Editor for Channel 4 news and she's been reporting on the crisis from the beginning – and is recording from the rather noisy news desk at Channel 4! Victoria. Welcome to risky talk.  Victoria: Thank you very much. It's great to be here.  David: Tracey Brown OBE is the director of Sense about Science an organization which campaigns for transparency in policy making. Welcome Tracy.  Tracey: Hello, David: And finally Christina Pagel is the professor of operational research at University College London, and a member of Independent Sage a rebel group of scientists offering evidence based policy advice to the government, and whoever else wants to listen, as an alternative to the official ‘Scientific Advisory Group for Emergencies’ or SAGE which we’ve heard a lot about here in the UK. welcome Christina.  Christina: Thank you. I'm not sure we're rebels, but thank you…! David: So each of you is an expert in a different part of the communication process with a range of different audiences. So Christina, let's start with you. You're a scientist communicating science to policymakers as well as the public. Can you tell me a bit about your role with Independent Sage: why it was set up and how you see the scientists’ role in communication during a public health crisis like this?   Christina: Sure. I think with Independent SAGE, it was set up right at the end of April at a time when we didn't know SAGE membership, there weren't any SAGE minutes and it became increasingly impossible to tell when the government said we're following the science to assess that, were they following the science? And it felt like they'd moved by that stage from the kind of very clear, stay home message, to stay alert, which was a lot vaguer. And so the kind of thing was set up to try and communicate what we knew about COVID, to have a conversation with the public about policy options over the coming months, but also to kind of provide just advice and what we thought could be ways forward in the pandemic. And it was always intended to be kind of constructive looking forward and not critical looking backward. And my role, I'm guessing I was asked on because I do a lot of mathematical modelling in healthcare, although I'm not an epidemiologist, but my role has become a lot more about the communication side. So for instance, since the government stopped doing its daily press briefings, we started a weekly briefing on Friday where we kind of just go through the latest government figures and just explain them. And I take that really seriously. I think it's really important that I get it right, but also show where we don't know things, where data is missing, as well as what data there is and what it's showing. David: So how much do you think your role has changed to communicating directly to the public rather than giving government advice? Christina: So when we first started, we didn't really know exactly where it was going to go. And it just seemed that as we started, the more we carried on the less the government was doing in terms of communication and the more confusing things got. You had the Dominic Cummings thing, which muddied the waters in terms of communication. Then you had lots of openings, you had schools, shops, bars, and now gyms, face coverings, where there's been a lot of really confusing messaging. And so what we've been really trying to do is say, well, this is the evidence that we know about COVID. And as far as possible, we try and use SAGE minutes that have now been published to support that evidence. And this is what it might mean, and these are the risks, and these have potential benefits. And we've started these public consultations on YouTube where members of the public can come in, they ask questions, we take questions from Twitter, we respond. I think actually that's been quite unique and it seems to have created, we've got quite a following now, people say, "We really find it very useful, the kind of explanations you're giving." David: So you're exploring communication as a two way process? Christina: Yeah. David: So I'd like to come back later to how you dealt with the media. I'd like to move over to Tracey. So your organisation Sense about Science has been advising government on better communication of its scientific reasoning and decision making process. How do you think the government, what do you think they should be doing in this context about telling the public about why they're doing what they're doing? Tracey: I think one of the biggest challenges here is the way that government internalizes the public that it's talking to. What Sense about Science does is we make the public interest case for sound science and evidence. So that's the perspective that we're looking at this from. And the challenge we have is that the public that is internalized by government, particularly when you have such a huge centralization of communications as you have in managing the pandemic is one that you sell a message to. So it's not one that is interested in the evidence. But there is a public that's kind of missing from government communication, which is the one that I think encapsulates most of us at the moment, are trying to reckon our way through what does this mean for me? There are many different kinds of risk messages that are coming across, what we're seeing around us, what our common sense might tell us, and so on.   "..the public that is internalized by government is one that you sell a message to. So it's not one that is interested in the evidence. But that public is missing from government communication, which is the one that I think encapsulates most of us at the moment."   And that's something that I think is missing. So my concern is that that's got worse. What started out very much with a tone of levelling with people that we really don't have the facts at our fingertips, we're going to find our way forward. The best we can say at the moment is we're getting the best advice and this is from whom. And then from there, what you've seen is this kind of concentration of control and messaging in a way that just does not open up the discussion in a way that people need in much more nuanced way. David: I know that Sense about Science has always had their Ask for Evidence campaign, way before this crisis, of in a sense encouraging the public to demand the reasons for what's being recommended for them or what they're being instructed to do. Tracey: Yeah. And that's been a very good thing. But I mean, who do you ask? That's been very difficult, actually. There were no public-facing government platforms for sharing information in a way that would actually respond to people's questions, no interaction. The daily press briefings was all there was, and I don't think they were very satisfactory for journalists, nevermind the rest of the public. So now I think Parliament has got its act together, that's at least a good thing. There are MPs now raising those questions through the floor of the house, and you've also got the committees becoming very active. David: Very interesting. Now I'd like to come over to Victoria now, as a news and health journalist, you're often communicating science to the public acting as this intermediary between you all these different communicators and their audiences. How do you see yourself in this role? You've got the government, you've got the scientists, you've got the public. What is your role when it comes to encouraging the flow of information between all of these? Victoria: I saw my role at the beginning as, obviously, trying to weave my way through this barrage of information. And I also saw my role as needing to be pretty calm and measured, especially in the beginning when people were frightened and trying to distinguish between the scary stuff that was coming out and the more practical briefings that we were getting right at the very beginning. It was enormously helpful. And you had that feeling that even if they couldn't answer your question, it was because they probably didn't know the answer rather than that they were holding things back from you. Of course, that has changed as the pandemic has gone on and our need for transparency has become even greater. The tension between the politics and the scientists has become ever greater. We have had to go to different sources like independent SAGE or the Science Media Centre, and to speak to the scientists themselves rather than trying to take the government interpretation of the science. The messaging has been very difficult and as the person that has meant to convey that messaging it has sometimes been an absolute nightmare. David: I think this is extraordinarily important. All of you have raised the issue of listening to the audience, getting feedback, understanding their concerns, but also the difficulty of actually doing this in practice. And maybe it hasn't actually improved as the crisis has gone on. Now, this podcast is called Risky Talk, so let's talk about the communication of risks. This is incredibly difficult, of course, because we're talking about people dying and thinking about these health risks can be very frightening. And communicating the real size of these risks is difficult. On the one hand, you don't want people to overestimate it and be over anxious, and on the other you don't want people to be careless. Now, Tracey, you've recently co-signed a letter accusing the UK government of failing to be clear about the risks. How do you think the risks should be communicated by governments? Tracey: Well, I think there are three things. One is that quite simply there is a reluctance clearly to talk about things that are low risk or lower risk. And obviously there's always that defensiveness of being afraid that you might say something that then turns out not to be quite that true and all that kind of thing. And being accused of being accused of underplaying a risk feels to politicians always far worse than being accused of overplaying it. So I think that's kind of the modus operandi of government at the moment is to behave that way. The problem of course, is that people's real lived experience isn't that, it is that it's much older people who are most at risk. There is a danger that if you're very generalized and not telling younger groups that they're far less at risk of having serious disease and dying, then that you flatten out that risk and then perhaps people aren't taking as seriously the quite extreme threat. So it's a much older group, particularly those with underlying conditions. So I think that's the first thing, is just to be much more clear and differentiated. I mean, indoor outdoor risk is a good example of that too, which is that studies are finding that sort of in the region of 97 to 99 point something percent of transmission events have happens indoors or if outdoors, then in the kind of confined spaces like events that have sort of similar conditions to indoors. At the same time that's going on, we've got politicians being derogatory about pictures of people crowding on a beach. Again, very confused kind of messaging about what's safe where and so on. So I think some just straightforward clarity about those risks would be good. I think the other thing that is needed is a bit more information for people about what is being factored in. Vitamin D deficiency appears to be a really big part of this picture. Does government know about that? Are ministers taking that into account? Is it in their briefings? I mean, that's the kind of thing that people need a bit more information about what is government thinking about and how is it weighing up different factors? And then finally, I think there's a feeling of lack of candor about the way that different types of risks are being traded off. And for example, the concerns that people have had about the people who have not been going to hospital for other conditions, there's definitely some evidence that's pointing to some pretty unpleasant outcomes there. The concerns that people have about the huge impact on people with dementia of being socially isolated. The concerns being raised about children not being in school, in terms of development and so on. And so I think those sorts of trade offs, people are assuming government's making them, but we don't know whether or what basis they're making them. And so I think that is a very important area for more straightforward conversation. David: Something I've been very interested in is the low risk case. Because there is this massive gradient in terms of the risk to the individual according to their age, and younger people, in particular school kids, are actually of extraordinarily low risk, which I've pointed out and have been criticized for. Do you feel there's been a deliberate policy in effect to not say that to people? Because it might lead young people to say, "Oh, well, I don't care it's nothing to do with me. I'm just going to go out and ignore all these messages." Tracey: Yeah. And there's the irony, isn't it? At a time when government is asking for people's trust, what it also communicates is that it doesn't trust the people with the information. And this idea that people were... this sort of zoning in on a handful of people partying in a pub and things like that, that's the kind of picture of this wanton abandonment with which people have behaved. And so I think there's an element of that. I do think there's probably somewhere, in some cases, a lack of confidence with the data and governance. So I think there is a lack of confidence in saying clearly to people, this is where the risks are most worrying. "At a time when government is asking for people's trust, what it also communicates is that it doesn't trust the people with the information." David: I'd like to come to Victoria on this because you're communicating to the public. How have you found reporting the government claims about the scientific basis for their decisions when actually the government, they're not scientists? How have you found that? Victoria: Well, it's been very difficult of course. And that comes back to this tension between politics and science. And you could also see at one point where the ministers were beginning to think, "Oh my God, what if we've got this wrong? Okay, we better blame the scientists." And so it was all about that whole thing at the Downing Street briefings of saying, we're following the science. And of course, then you couldn't see the science, which proved very frustrating, until SAGE started publishing its papers, but they were somewhat after the effects. So the interesting one there was on schools, for instance. So we got those papers on the day that they announced the school closure. So you could actually see what had been discussed at SAGE and compare it with what the government was doing and what the political decisions were as opposed to the scientific decisions. And where there has been difficulty with transparency has on the whole been on the political side. David: I'm very interested in this because I've also been intensely irritated by the briefings. And this phrase, following the science, makes me want to scream and shout because it suggests that science is some monolithic body of facts that's leading the way and telling everyone what to do when it's far from it. It's uncertain and contested. I've been trying to think of a better phrase, something like, we're listening to scientific opinion, might be a fairer from a political perspective. "And this phrase, following the science, makes me want to scream and shout because it suggests that science is some monolithic body of facts that's leading the way and telling everyone what to do - when it's far from it!" Christina, this obviously is so relevant to independent SAGE. I was just wondering how have you managed with dealing with the media with reporting to the public, with being that voice for this independent group of scientific opinion? Christina: I mean, I have to say the media side of it was something I wasn't expecting. And everyone on independent SAGE is now on the media quite a lot, the others more than me, and I haven't really had much experience before this. And I think part of it is because you just don't have many of the SAGE scientists going on media, you don't really have the government commenting. And so there has been this kind of first from news and radio, TV to kind of go on and explain things. There's been things from News Night to I went and did the Daily Mail health show, and a lot of it is just literally trying to kind of condense what I've done from reading the SAGE minutes, from reading the evidence, from listening to my experts on independent SAGE, to looking at all the government data and reports, looking at what's going on around the world, and trying to condense it and say, this is where we are. This is what we know about the risks. A lot of stuff around social distancing, duration of contact, indoor versus outdoor, face-to-face versus side-to-side. This is where we are in terms of infections. This is what we don't know. This is how well tests and trace is working, kind of mediocre. And this is where we are in comparison to other countries and where we could be. And that's kind of ended up what I've been doing. And some of it has been quite standard kind of public health messaging, which is a bit odd as a mathematician, but on the other hand someone has to do it. And I felt like if I have a platform to be able to say to people, please try and remember, hand-washing, don't touch your face, a bit of social distancing where you can, then I should be doing that. David: You've actually found yourself in the role of giving people public health advice. But we know that so difficult because for public health messages to be effective, they've got to be clear, and simple, and trustworthy. And that's pretty easy for uncontroversial advice like hand-washing, but what about what we're dealing with this new virus where the evidence can be very uncertain? What about face masks, for example? Classic case, scientific communities there's quite legitimate argument and discussion about the uncertainties, but does actually airing that discussion undermine or enhance public trust in the evidence and their willingness to wear masks? So how can these discussions be held? Christina: I can start because Independent SAGE literally just released its document on masks, face coverings. We had a public event where we took questions from the public and explained our position, which is that we do think face coverings should be used, that there was a lot of uncertainty in the evidence, the evidence that isn't great, but the balance of evidence is growing towards masks being a good public health intervention, mainly in protecting other people from you if you were infected. But we emphasize that it's not a silver bullet and it has to come with a big public information campaign on how to wear them, when to wear them, what kind of materials, that it's part of a suite of other protective behaviors like social distancing, hand washing, not touching. So it has to kind of come together and it has to be done in a way that's not punitive, so that there are people who are legitimately not in a position to where face coverings and we shouldn't be creating a situation where they're attacked or feel ostracized because of it. We have to understand that. So in a way that's kind of how we've been trying to do it is say, okay, well, face coverings is one part of how you would protect your population from COVID. David: So Christina, you're describing a direct communication from the science community to the public? Christina: Yes. David: Victoria, so how do you think the media should deal with these sorts of discussions about the evidence? Do you feel that there's a conflict between the public health message and this nuance? Victoria: Well, it comes back to the whole messaging problem in a way. Is that you needed one or two very succinct, very stark messages to persuade everybody to socially distance, to stay indoors, to protect the NHS. And I think as the pandemic has gone along, it has become clear that this hasn't worked entirely well in terms of the subtleties that lie behind it, I don't feel has been particularly well-communicated. And maybe it's because they know that the government polling showed that, for instance, stay at home, protect the NHS played very well. But maybe there is a way of making the message more subtle now that people have become used to this pandemic and used to the idea that it requires something from all of us. And it goes back also to this idea of differential aging risk, because you could tell young people, yes, you are less at risk, but what you can't tell them is how much they put at risk their grandmother. And that's where the communication becomes very difficult. David: So, Tracey, do you think the government and some sections of the media have underestimated the public's ability to take on this nuance around evidence and messages? Tracey: Well by and large I think people are pretty good at that stuff. The best people to take care of your grandmother is you. And I don't think that, when you look across what's been causing the high numbers of deaths in the older age group, it isn't the reckless behavior of their grandchildren. And people have really taken to heart that need for social distancing. You've had people who haven't met their new grandchildren until sort of six weeks or eight weeks in or still haven't. And so I don't think there's any reason for anything that we're seeing around us in terms of people's behavior to be overly concerned that people haven't got the message on that one. And it's quite possible, in a sense, by emphasizing who isn't at risk, you can also emphasize the incredibly high risk to older people. But David, can I say something about this whole sort of mask situation and what's also being communicated there? The purpose of the government's introducing masks into shops is ostensibly, and then what I hear behind the scenes as well, to get people to be more confident about being able to go back out, because 60% in polls are saying that they're scared of going and conducting themselves in normal life. Government's big concern is to try and get everyone back into normal life to try and reduce the economic risks to everybody and so on. But what, of course, happens is that we take our risk readings from the things that are going on around us. And if we see everybody covered in masks, then it actually reinforces the idea that that's a very dangerous place to be is in your local supermarket. And I think we need to look at that on balance. If the government's purpose here is to give people more confidence, I'm not convinced that actually mandatory mask wearing is going to deliver us that. It might deliver us other things that people are saying in terms of transmission, but I'm not sure that it's going to convince people. David: Well, that question of what is the aim of the communication is a really key point here. At the Winton Centre, we're always banging on and on about the difference between aiming to inform people and aiming to influence them to change their behavior. As you say, public health information, and in fact, almost all of what government is used to doing with its communication, is trying to influence and persuade. Perhaps it's been a bit too successful with persuading people to stay at home. And what you are aiming for changes, of course, what success looks like to you. So can I go around the table and ask, what would you see as a measure of success for different kinds of communication? Tracey, what do you think the government should be trying to achieve in it's communications? Tracey: Well, I think at this point in time, it's quite an enabling thing, isn't it? So, people are very aware of the need to resume some of their activities, all of their activities, particularly when it comes to work. You only have to have a quick scroll through Facebook or Instagram to see the extent of people's troubles with having kids at home for 24 weeks and I think it's an enabling thing that people need in terms of day to day life. And many of us, in many ways, take responsibility for other people too. Some of us manage other people or have employees or colleagues to look after, run buildings, all sorts of things like that. So I think at the moment, there is a real hunger for decision making and you see it at the level of local authorities as well, trying to sort of decide which events can go ahead and which can't. We're making many, many decisions from individual level through family, through community, up to government. We're making so many decisions or having to make so many decisions and people do not feel like they've got what they need at their fingertips. David: So it's actually very much what we try to do when we're helping people with health advice. It's crucial for people to feel that they've got the information available to enable them to make an appropriate decision. Tracey: Yeah. And that doesn't necessarily mean that we're all going to agree it's the right one. David: Yeah. It doesn't mean you're all going to do the same thing, but at least you feel you've got the better information. Christina, what about you? The communication that you're doing, both direct to the public and to the government, what would be a success for you? Christina: Success for me, honestly, is if the government improved its own messaging, because they're the ones that should be explaining to the public about what's going on. And for instance, say they've launched this test to trace system, but how many people would actually know that if they have symptoms, they should get tested? If you go right now to gov.UKcoronavirus, it has five bullet points at the top and it doesn't mention getting tested. It says, stay at home if you've got symptoms. And you have to really search through the pages before you get advice on that. And the whole way it works is you have to find as many people as you can with COVID and ask their contacts to isolate, and we're not doing that. We're not capturing how many people that we're not testing. And we also aren't capturing how many people are isolating at the other end, and isolation of contacts is an entirely voluntary thing, and it's a really hard thing to do when you feel totally well. But that is absolutely key to stopping spread. And without real communication about why should you be isolating if you're contacted, what are the benefits? How does it work? How does it help? How can we help you do it? You're not going to get that. So it's that kind of criteria that I would measure success on. David: Good messages, appropriate messages, prominently provided. Christina: Yeah. And also to kind of disadvantaged groups or ethnic minorities, we know that they are much less aware of even the symptoms of COVID, social distancing measures, all of that stuff hasn't really been provided to kind of different contexts. David: Victoria, as a journalist, how do you measure your success? Victoria: Well, I think the channel measures the success, but I did get promoted partway through this, so I'm hoping that's an indication that I'm doing a reasonably good job. Right at the beginning, I also took a decision to say on air, I don't know the answer to this. As time has gone on, I can't say that because there are many avenues now that I can go to, but right at the beginning it was such an uncertain science, such an unknown virus, I took the decision that I needed to be almost an open about where we could get the information and when we couldn't get it. And of course, because I come from New Zealand, I looked very closely at what's happening there in desperate hope that I can one day get back to see my parents without going into two weeks quarantine. And I've been very impressed at the messaging there which was, at the beginning, "Look, we just don't know. It's still too uncertain." And I think that needed to play a bigger role there because everybody knew that it was a new virus, that there was a great deal of uncertainty, and also that some advice at the beginning would change as the science became better. We're running in parallel in a way. There's the public health message, and it's about trying to find the right public health message, also running on parallel what's the science that backs it up? So for it to be really successful, you need to have them say, for instance, this is why it's two meters here, why it's one meter at the WHO, why it's one and a half meters in other countries, and have it much better explained rather than just us journalists having to say it, actually have it there in the public health messaging, David: I suppose I'm interested in both things you said there, first is the need to acknowledge uncertainty. Something we go on about all the time about being open about uncertainty because that's part of being trustworthy, but also the need to give, in a sense, confident messages out to the public. And they are quite difficult to reconcile. I mean, Christina or Tracey, do you think we can communicate uncertainty without losing trust? And if so, how do we combine that with confident, clear messages to the public? Tracey: Well, I think that the crucial thing with public health advice is that it needs to be simple in the sense that when it's directive, it needs to be kept quite clean and tidy. So we know this from the past of communicating risks to pregnant women. For example, we know that when there were attempts to try and tell them about every little thing they might have heard of as potentially posing a hypothetical risk in pregnancy, what happens is you see a drop off of people taking folate, because what they start to do is pick and choose from the list of risk mitigations that are presented to them. Which is kind of a similar worry we have now, isn't it? That hand washing kind of disappears down the list of 20 other things that you've been told to do that are a bit more complex. So directions should always be really simple and kept to the minimum of the most important ones, they should be really prioritized. Explanations can be messy. And I think that's where you share, in an accountable way, this is about accountability for your decision making, and that's where you share the different things you're taking into account, the different weight that you're giving them, and create the expectation that that can change. One of the things that I think, both Victoria and Christina have sort of referred to this in different ways, at the start of the pandemic there was definitely a we we were all in this together, there was a public expectation that new stuff would emerge and the picture would change. And I don't think that's particularly gone away actually, if anything, I think we're all sort of looking forward to seeing what's going to emerge about the next year and the whole discussion about herd immunity coming back and so on. So I think there's an openness there. One of the most exciting things I think about the kind of discussions that people have got into is so many people that you would never have dreamed of being in a discussion about the nature of uncertainty with, are up for it. I had an online discussion with a bunch of MMA cage fighting warriors about this question of uncertainty and the data. I mean, it wasn't a discussion I imagined having at any point in my 20 years of trying to talk about risk communication. David: Okay. We're coming to the end now and I'm going to wrap up by asking a simple question to each of you, maybe not so simple. What do you think is being communicated well, and what's been done very badly during the pandemic? By all the different sort of actors in this drama. Let's start off with Tracey, what do you think the government has actually done quite well? And what do you think it has done really badly? Tracey: I would say, besides what I just said, that the hand washing message at the beginning was good, was really, really good, really clear. Everyone got it. What has been probably the worst communication has been around schools, and school children. And there's been talk of super spreaders, there's been all sorts of things going on that are just patently untrue. And I think government has given no serious leadership in this area, either to the communication of the risk or to the management of the risk. David: Right. Okay. Victoria, what do you think the media have got right? And what do you think the media has made a bit of a mess off? Victoria: I can't actually think of a mess. I'm sure other people could, in a way that I think the media has on the whole been quite responsible in its reporting. And I think part of that has been that we have had very good background briefings. We've had the briefings from you guys, we've been helped along the way. Also it helps, to a degree, that many of us have been health journalists or science journalists for a long time. So from my perspective, as awful as this is and as distressing and frightening, I personally fell this is all my years of health journalism coming together, being able to understand epidemiology, communication, public health messaging, and so on. It's been interesting. David: Victoria, I can't resist asking you then, how do you feel as a health journalist when the political journalists start getting to ask all the questions at the briefings and so on? What do you feel about the political journalists or the general journalists getting involved in all of this? Victoria: Those briefings were a little bit frustrating, not least because Channel Four News quite often didn't get a question either from the political editor or the health editor, which was a bit sad. But, yes, there was a frustration on our part because we felt, I think as health journalists, that we would have had more direct questions to the chief scientific advisor, or the chief medical officer, rather than trying to score a political point, as it were. David: Yeah. I would agree with that. Can I also say that as someone who's been trying to work with the media throughout this, it's been going, in general, very well indeed. I think partly because the media, they so need the scientists that they've been quite nice to us. Okay. So, Christina, what do you think, I know it's a huge thing, the scientific community is a great, massive, diverse thing. What do you think they've done well in terms of communication? And what do you think has been communicated badly do you think? Christina: The scientists that I have seen on the media or in newspapers, I felt like actually they're doing a pretty good job of communicating how much this is a new disease and how we're learning about it and where the uncertainties are. What I think has been done less well, and I don't know this is the job of the scientific community, is explaining how given the uncertainties and the evidence, how you then make decisions. So given that, say, we had uncertainty around the role of children in transmission of COVID, how does that then feed into whether you decide to open schools and how you do that safely? So I think that has kind of been missing. Can I just say one thing, my bugbear of communication in general is this idea that we should all use common sense. Because I don't think there's anything common sense at all about a pandemic. We're actually being asked to do things that are deeply unnatural, like not hugging people, not talking to people face-to-face, staying away. I just think common sense is actually counterproductive and really, really unhelpful. David: David: Yes, that’s a very good point. So just to sum up, then – I think we agree that governments, scientists and the media all share similar roles when communicating in a public health crisis like this. When the evidence is clear and uncontroversial, like handwashing, then we can be clear and simple in our messaging – with an aim to change behaviour - but give people the reasons behind the messaging too. When the evidence is uncertain and emerging, we should all be upfront about that – tell people what we know and don’t know at the moment, try to update it as quickly as we can, but in the meantime try to help people weigh up the risks and benefits to make the decisions they need to. And when difficult policy decisions are being made, everyone should be transparent about the basis of the decision: that one harm is being weighed against another benefit. It’s quite a change for governments, who are not used to this kind of messaging, and it’s hard for some journalists, who are perhaps not used to dealing with really in depth scientific research. And it’s hard for scientific researchers too, who may not be used to communicating to policy-makers or the public. So it’s perhaps not surprising that many mistakes have been made. I just hope that some of these lessons might be useful to communicators of all kinds in the next few months. Many thanks to my wonderful guests, Victoria Macdonald, Tracy Brown and Professor Christina Pagel for helping us through this most difficult of topics and at such a busy time too. It’s goodbye from me and the Risky Talk team. ***

Om Podcasten

How can we best communicate the risks and the evidence on the most pressing issues of the day – from genetics and nutrition, to climate change and immigration? David Spiegelhalter is joined by the world’s top experts to tackle urgent, practical challenges which affect us all.