Time to Refocus Our Efforts on Plain and Clear COVID-19 Messaging: Introducing the Clear Health Communication Collaborative (CHCC)

by Michael Villaire, MSLM and Barbra Kingsley, Ph.D.

The third anniversary of the onset of COVID-19 is approaching, and here in the United States, as in much of the world, COVID-19 fatigue is a real thing. And there are troubling signs:

  • About 63% of U.S. adults say they only occasionally or never wear a mask outside their home.
  • Infections are on the rise in Europe, which has previously served as a bellwether for the United States.
  • Increased levels of the virus in wastewater, another harbinger of increased rates of infection, are being detected in some states in the Northeast.
  • Only about 11.5 million Americans, or 4% of those who are eligible, have received the new omicron-specific bivalent booster shot as of mid-October. About 1 in 3 others say they plan to get it.
  • Airline travel has come roaring back—up 135% this May from May of last year, according to Airlines Reporting Corporation—and few people are wearing masks on airplanes.
  • Predictions for a rough flu season are causing infectious disease experts to fear a twindemic. And only about half of Americans plan to get a flu shot this season.

The Government’s Confusing COVID Messaging

Meanwhile, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), amid a reshuffling of staff and accountabilities, recently commented on the agency’s COVID-19 public messaging: “In our big moment, our performance did not reliably meet expectations,” she admitted.

Speaking of CDC, on Oct. 7 the agency announced that indoor masks are not necessary for 99% of Americans because they live in a county with “low” or “medium” COVID-19 community level. With this recommendation, CDC puts demands on individuals by making the following assumptions:

  • People will know how to find out if their county is among the 1% with a “high” level of transmission.
  • People will understand what the risk is with low and medium transmission levels within one’s county, and where the dividing line is between medium and high.
  • People will be ready to pivot when the eventual surge comes in a month or so.
  • People will understand why they’ve been told to wear a mask, then not wear a mask, and soon, to wear a mask again.
  • Trust issues will not be affected by this back-and-forth messaging, and people will not see CDC as flip-flopping on its policies.

The capstone to all this may very well be President Biden’s recent comment on CBS’s “60 Minutes” that “the pandemic is over.” Never mind that the full comment was: “We still have a problem with COVID. We’re still doing a lot of work on it. But the pandemic is over.” With this sound bite, the unfortunate takeaway message here is that it’s over, we’re done, mission accomplished.

Adding up the net effects of all these factors is a chilling exercise. It only makes the job of public health and healthcare communications professionals more difficult.

A Better Approach to COVID Messaging: Health Literacy

This poor messaging speaks to the heart of effective health literacy and plain language. The burden for understanding and acting on health information shouldn’t rest with the public. Instead, it’s the healthcare system’s job to communicate clearly and effectively, use plain language, and ensure that its messaging is unambiguous, understandable, and actionable.

We cannot continue to put the onus on individuals to navigate COVID-19. Trust and clear, consistent messaging are key here. Thus, the healthcare system needs to understand its role in how its messages are perceived, and the extent to which they can really be used.

The Clear Health Communication Collaborative (CHCC)
CHCC logo

To that end, IHA and the Center for Plain Language have initiated a … what should we call it? A collaboration? A call to action? A movement? It’s all these things and more. The Clear Health Communication Collaborative (CHCC) represents an effort to raise awareness about the nature of the messaging we are putting out in the world.

Here are a few of the lofty goals we’ve set for this effort:

  • We believe in the power of plain language, clear and effective communication, and using health literacy best practices to ensure that anyone who reads or hears a health message understands, trusts, and can act upon it if they wish.
  • We want to move beyond our own silos in health literacy and plain language to get this message out to those in the healthcare system who need to hear it. We’re reaching out to CDC as a start, as the statements by Dr. Walensky and President Biden were two of the primary catalysts for this effort.
  • We want to offer our expertise and assistance to those who could use it. It’s pointless to tell someone that their message cannot be understood if they themselves don’t understand the concepts of health literacy and plain language.
  • We will call out and share both good and atrocious examples of public health messaging. When it’s good, we’re happy to pass along the kudos and share the example with our network. When it’s bad, we will offer, in constructive fashion, alternative ways the message might have been framed.
  • Speaking of network, we want to include all of you. This effort won’t succeed unless it has all of our DNA in it. As the saying goes, all of us are smarter than one of us. In the coming days, we’ll share social media sites and hashtags with you, and ask you to follow along and contribute.

To paraphrase the quote from the movie, Magnolia, “We may be done with the pandemic, but the pandemic is not done with us.” We may be in a lull at the moment, but with winter approaching, experience has shown us that this virus will come roaring back again. We need to be vigilant in our messaging; ensure that we are communicating clearly, plainly, and effectively; and work hard to build bridges of trust to the communities we serve.

We will be posting messages and recommendations on LinkedIn, the Center for Plain Language website, and IHA’s Health Literacy Solutions Center regarding the efforts of this collaborative. We invite you to share these messages, add your own, and work with us to ensure that we, as plain language and health literacy advocates, are doing all we can to make sure each and every person has the knowledge and resources to stay healthy and thrive through this pandemic.

About the Authors

Michael Villaire

Michael Villaire, MSLM, President/Chief Executive Officer, joined IHA in 2000. He sets IHA’s strategic direction and oversees coordination of IHA’s health literacy activities. Prior to working at IHA, he served as managing editor for a number of peer-reviewed medical and nursing journals and produced national healthcare symposia. He earned baccalaureate degrees in English and Communications from Western Michigan University, and a master’s degree in nonprofit organizational leadership and management from the University of La Verne.

Barbara KingsleyBarbra Kingsley, Ph.D., President of Kingsley-Kleimann Group, has 25 years of experience managing high-impact communication projects to create clear, usable information. She is an information design and plain language expert with a deep understanding of how individuals, particularly vulnerable populations, use print and online information. Barbra also works nationally and internationally to promote the use of plain language. As Chair of the Center for Plain Language, she oversees both the Annual Federal Report Card, which rates federal agency compliance with the Plain Writing Act of 2010, and the Annual ClearMark Awards, which celebrates the best in North American plain language.


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