As the United States deals with yet another winter surge in COVID-19 cases, albeit not as severe as in previous years, governments and public health experts are looking ahead to the next pandemic and wondering if the country is ready to respond.
Federal and local health institutions are already retooling or revamping operations as the pandemic enters its fourth year: Centers for Disease Control and Prevention director Rochelle Walensky plans to overhaul the agency having faced criticism for its response to the pandemic and public health departments across the country are working to improve how they communicate information with their communities.
Amid these changes, 55% of U.S. adults said they trust public health institutions to handle a potential future pandemic based on how COVID-19 is being handled, compared with 37% who said they do not trust institutions to handle response, according to a new morning consult poll. Meanwhile, 8% of adults said they didn’t know or had no opinion.
However, a key element to an effective response to a future pandemic will not only be whether governments and health agencies improve their emergency procedures, but whether the public will listen to them if they do.
“Trust has definitely gone down for public health institutions during this crisis and experience,” said Jennifer Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation. “It definitely presents an obstacle.”
Multiple factors have damaged the trust of health institutions
Kates, who helped lead KFF’s COVID-19 work, said there are multiple reasons for the erosion of public trust, including the complexity of communicating public health information, details that change rapidly during a crisis, especially early on, and the increased presence of agencies like the CDC or National Institutes of Health in people’s lives.
“We saw public health front and center every day,” Kates said. “Part of that is that there’s almost a face to this response that people might not necessarily have known about before.”
Another factor contributing to the decline in trust in public health institutions is that the pandemic has been “incredibly politicized,” Kates said, with partisan divisions over messaging and public health measures like wearing masks or getting vaccinated.
These gaps are reflected in the survey: Among respondents who said they trusted institutions “very much” to handle the next pandemic, nearly 2 in 3 were Democrats, while Republicans made up more than half of those who answered “not at all.”
Democrats, older Americans are more likely to trust public health institutions to handle a future pandemic
Demographic profile of US adults who said they trust public health institutions “very much” to handle a potential future pandemic and those who said “not at all”
Survey conducted December 14-19, 2022, of a representative sample of 2,210 US adults, with an unweighted margin of error of +/- 2 percentage points. Figures may not add up to 100% due to rounding.
There was also a generation gap: Baby Boomers made up 45% of those who said they trusted health care institutions “very much”, compared to 26% who said “not at all”. Gen Zers and millennials, meanwhile, make up a larger share of those who don’t trust public health institutions about future pandemics than those who do.
Americans trust health agencies more than the White House for information and news
The CDC announced a step in its review last week, to hire Maine CDC director Nirav Shah as Walensky’s second-in-command. More changes are on the way as the country’s top public health agency grapples with a public that is looking at it more critically. Net approval for the agency’s handling of the pandemic (the share of those who approve minus those who disapprove) plummeted from plus 70 in March 2020 to plus 24 in December 2022, according to a Morning Consult. pursuer.
Vish Viswanath, a professor of health communication at Harvard’s TH Chan School of Public Health, said there had traditionally been a high level of trust in health care institutions before the pandemic, but the CDC and others “have taken a real hit.” in the last three years. He, too, cited politicization and miscommunication during the early days of the pandemic as reasons for the decline, including inconsistent messaging about mask wearing.
Despite these messaging errors, the majority of the public agrees that many of these coronavirus mitigation measures have been effective.
Americans say social distancing, vaccines and masking are the most effective strategies for managing the COVID-19 pandemic
The percentage of US adults who said the following measures to stop the spread of COVID-19 were effective or not:
Survey conducted December 14-19, 2022, of a representative sample of 2,210 US adults, with an unweighted margin of error of +/- 2 percentage points. Figures may not add up to 100% due to rounding.
And despite declining approval for healthcare institutions, Morning Consult data shows that nearly 2 in 3 U.S. adults said they trust public health information from the CDC and NIH, compared with just under half (48%) who stated that they trusted the information from the White House.
A biased division emerged in these responses: Democrats were more likely than Republicans to trust information from the three institutions surveyed, especially the White House (71% vs. 25%).
The public is much more skeptical of the White House than CDC, NIH for health information
The share of US adults who said they trust the following for public health news and information:
Survey conducted December 14-19, 2022, of a representative sample of 2,210 US adults, with an unweighted margin of error of +/- 2 percentage points. Figures may not add up to 100% due to rounding.
A spokesman for the Department of Health and Human Services, the home agency of the CDC and the NIH, said in an email that “the erosion of trust in our public health institutions is a real problem that damages our ability to to keep the public safe and healthy That’s why HHS is committed to ensuring that the nation’s public health guidance and messages are based on fact and science, and that we are transparent about what we do and don’t know.
The spokesman stressed the “We can do it” public education campaign to help fight COVID-19 misinformation as an example of an ongoing and related agency initiative. The White House did not provide a statement when asked for comment.
Whether politicization has contributed to a permanent loss of public trust in public health institutions is hard to say, both Kates and Viswanath said. But it could be a crucial question if there is another pandemic, as people may not follow recommended public health measures based solely on political identification.
How the United States responds to another pandemic will not rely solely on the CDC, Kates noted, but also on Congress and other agencies. She said the CDC needs to be more transparent about data and information, as in Walensky’s report, but the US should increase funding for public health agencies and improve local public health infrastructure that has been depleted by the pandemic.
Viswanath said time will tell whether efforts by the CDC and other agencies will have an impact, but he doubts the country has learned the right lessons from COVID-19 yet. Work to improve communication processes and public health infrastructure should start now, he said, because another emergency will inevitably come.
“You can’t build trust during a crisis,” Viswanath said. “Trust is something you build over time, that you draw upon during a crisis.”