Misinformation, data uncertainty and the cat scale of wellbeing – global lessons on knowledge exchange during a pandemic

While the evidence base on successful practices in knowledge exchange is growing rapidly, the COVID-19 pandemic presents unprecedented global challenges. During an online taster event for the upcoming Fuse international conference on knowledge exchange in public health, international experts shared their learning from the pandemic.

Perhaps the biggest challenge during the pandemic has been communication. Governments demanding quick access to the latest scientific evidence to inform their decision making in the fight against COVID-19; researchers dealing with a lack of data and uncertainty in interpreting emerging data on spread of the virus and risks to health; and both struggling with the spread of misinformation on social media and in other places of power

In spite of these challenges, awareness of public health and research evidence has increased significantly during the pandemic. Some public health figures, such as England’s chief medical officer Chris Whitty, have become household names (“next slide please) and ‘R numbers’ are now common knowledge. We learned to be more flexible in funding, designing and conducting collaborative research, with gold-standards being replaced by ‘good enough’.

Maureen Dobbins from the National Collaborating Centre for Methods and Tools within McMaster University in Canada, demonstrated how they were able to develop new synthesis methods and dissemination plans with local government to mobilise evidence for decision making within less than a month. For example, they conducted a rapid review on household food insecurity for the Public Health Agency of Canada with support from Public Health Advisor Leanne Idzerda. They dealt with uncertainty in these rapid reviews by grading the evidence by asking: ‘How likely are the findings to change with more evidence?’

As professionals, we learned to deal with the uncertainty of data by making better use of our personal connections. Roland Bal from the School of Health Policy and Management at Erasmus University in Rotterdam showed how Dutch clinicians mobilised their informal network of colleagues at the local, regional and national level to coordinate beds for COVID-19 patients across hospitals in the Netherlands and reduce uncertainty about available intensive care unit capacity. This resulted in a dedicated bus service for transporting patients between hospitals.

Existing monitoring and coordinating structures between hospitals no longer worked in the pandemic and were replaced with new informal ones, in which emotions and politics played a much larger part. Roland dubbed this the importance of ‘relational epistemology’ and also drew attention to the ‘dark side’ of these new coping strategies, where people outside these relational structures were seldom heard and the patient voice and experience not included.

However, researchers also developed new ways of engaging with their partners in research. For example, Jane Powers and Mandy Purington from the Bronfenbrenner Center for Translational Research at Cornell University, USA engaged with youth workers and health care providers in their ACT for Youth project by transitioning to innovative remote and virtual formats, including game and role play, using avatars. Part of these formats is an acknowledgment of the emotional impact that the pandemic has on partners and therefore the need to create a space in these activities to check in on partner wellbeing. Perhaps their greatest innovation is the ‘cat scale’ which Heather Wynkoop Beach from the Bronfenbrenner Center introduced during the event – which cats represent you today?

Finally, policy makers, professionals and researchers have had to learn to deal with misinformation about COVID-19. Peter Lurie, President of the Center for Science in the Public Interest, in Washington, D.C., USA showed that the actual amount of primary misinformation about COVID-19 is very small but can do plenty of damage, due to many people simply referring to it online. Of the 479,225 articles he found in his review on COVID-19 vaccines in a wide range of media outlets, only 3.7% contained misinformation, and of those only 3% contained what he called ‘primary misinformation’, with the vast majority of articles simply referring to a very small number of primary sources of misinformation. However, some of these articles were sent to more than 400 million subscribers, indicating that the reach of misinformation can be vast!

C-WorKS: COVID-19 Consequences – Want it? or Know it? Share it!

To counteract misinformation and lack of knowledge, Mia Moilanen, who works as an Analytical Programme Manager at Public Health England* in the UK, demonstrated an online knowledge sharing platform called C-WorKS, which was developed during the pandemic. On this platform, health professionals, service commissioners and academic researchers across North East England and Yorkshire share knowledge, expertise and resources on the non-COVID consequences of COVID-19 (e.g. delayed representation of other health conditions, mental health and increasing health inequalities). So far, over 700 members have shared more than 300 resources through C-WorKS.

What the pandemic has taught us more than anything, is the importance of collaboration: to work together to find solutions and that, during public health crises, we need to find new ways of connecting knowledge users, producers and brokers. This requires flexibility in roles, structures, research methods and funding arrangements, which will have a lasting impact on the future of knowledge exchange in public health. We hope to address the complex challenges faced during the pandemic, what we have learned about knowledge exchange, and how we can use this knowledge to improve research and practices in the future at the Fuse conference next year in June in Newcastle, UK. We can’t wait to see you there!

*Public Health England has been replaced by UK Health Security Agency and Office for Health Improvement and Disparities

This blog has been reproduced with permission from the Fuse Open Science Blog: 

knowledge mobilisation policy making public health science communication

Scientific communication during a pandemic: slogans, ethical dilemmas and performance managing MPs

Sometimes science is more art than science, Morty. Lot of people don’t get that” (Rick and Morty, 2013)

Never before have science, research and evidence been so central to government policymaking, so widely discussed in the media and in public discourse, and so controversial and contentious especially in debates on social media.

Last week, the HSRUK conference 2021  hosted a plenary session titled ’Science, evidence and government policy: lessons from the COVID-19 pandemic’, chaired by Kieran Walshe. During the session three experts related their experiences of science communication with government during the pandemic, including Christina Pagel, who is a member of the Independent SAGE group and Director of Clinical Operational Research Unit at UCL; Chris Gopson, who is Chief Executive of NHS Providers, and Sarah Hopson, a GP and former MP for Totnes.

What their reflections highlighted was a skills gap at both ends: academics need to work with slogans and wrestle with ethical dilemmas when presenting key messages, while policy makers need better performance management that includes training on understanding and using research evidence.

Chris Hopson set the tone of the debate by distinguished two ways in which national leaders prefer to communicate about science during the pandemic: the first way, represented by the UK, likes to keep it short and simple, is in favour of repeating snappy messages with key slogans (e.g. Hands, Face, Space), and does not want to elaborate in much details or recognise any uncertainty in the messages they are communicating. In contract, countries like Germany and New Zealand prefer a more open and transparent communication strategy, in which they are happy to go into detail, share uncertainty in the evidence they are presenting and acknowledge the challenges and risk of the decisions they are trying to make.

Chris was in favour of the second strategy, arguing that the quality of decision-making is improved by transparency and openness in public debate about scientific data and its interpretation. However, session participants pointed out that this strategy does not always work in the favour of scientific advisors at No. 10. The example was shared of Professor Chris Whitty, Chief Medical Officer for England, complaining about the challenge of convincing the government to act on research data, while the scientific community is divided on the proposed actions and openly debating on Twitter against the measures that he is urging the government to take.

Chistina Pagel offered some tips from her experiences as spoke person for the Independent SAGE group on how the manage the balance between openness and consensus. First of all, don’t try to put too much detail in your briefings for policy makers. As a science communicator you need to understand the detail but only present the key messages to policy makers. Teasing out these messages involves a careful process of piecing together the various sources of imperfect information  and weighing them up carefully with a consideration of their context. Christina suggested guiding questions for shaping these messages: are things getting better or worse? What can we do to change the trajectory emerging from the data?

She acknowledged the challenges in this process, for instance, the ethical dilemma of being truthful but not putting the public off (e.g. people not going to hospital or accepting vaccinations because of rising infections in hospital and rare health risk of vaccinations). In piecing together the research, time is never on your side: there is a lag in the reporting of data (e.g. infections translating into hospital admissions), so you are always working with imperfect information, but you don’t have time to wait for more rigorous trial data. And when you data suggests an exponential growth in cases, this often clashes with perceptions of policy makers and the public that “things are fine” at the moment and therefore have no appetite for reintroducing restrictions.

Learning how to navigate these challenges is a core skill for researchers who often prefer to run a mile when faced with political values over objective data. Or as a session participant put it: the role of campaigning does not come natural to scientist. Scientists need to get better at the art of communicating their science. Christina’s top tip was to be compassionate with the audiences you are communication with, who often experience more difficulties from COVID-19 than you and, therefore you need, to be mindful of how you relate your key messages to their experiences.

But not only scientist needs to change their game. Sarah Hopson lamented the lack of research training for MPs by criticising that policy makers are only being performance managed on whether they turn up and vote. From her own experiences in Parliament, she recalled hoe MPs are ignorant of research and not supported in how to use evidence in their decision-making. Moreover, MPs have often no experiences of managing large organisations and yet are asked to make decisions on how to run large structures, such as the NHS.  She pleaded for more continued professional development of MPs that include training on understanding evidence and how to manage large organisations.

Scientists can support MPs in their professional developed by making them aware of their research. Sarah made a plea for not underestimate the importance of evidence submissions to Select Committees and by talking to your local MP to share your research and discuss what it means for policies that they are interested in. This doesn’t have to be in slogans or bended truths; quite the opposite: embrace uncertainty by letting policy makers know when we don’t know what course of action to take; and be willing to learn from mistakes by being reflective on our communication with policy makers.






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