Since the inception of the novel coronavirus COVID-19 pandemic, local health departments (LHDs) have been working nonstop to inform communities of the risks of the virus, as well as ways to keep themselves, their families, and their staffs safe. As seen with previous public health outbreaks including Ebola virus disease, severe acute respiratory syndrome, and the Middle Eastern respiratory syndrome, it is critical for LHDs to have a comprehensive risk communications plan to mitigate the spread of COVID-19.
A lack of communication or disseminating inaccurate information can result in distrust from the public, a questionable reputation, or even loss of life.1 Through effective and strategic information sharing, LHDs can make better informed decisions before, during, and after a public health emergency, thus protecting their communities. The Institute of Medicine suggests that risk communications plans help build resilient communities and long-lasting emergency response systems.2
Using Social Media in COVID-19 Risk Communications
Social media is a critical communication channel for not just routine, nonemergency information but also for delivering critical updates during public health emergencies. In 2017, it was found that approximately 67% of Americans got some of their news from social networking platforms.3 A 2016 survey conducted by the National Association of County and City Health Officials (NACCHO) indicates that only 40% of LHDs use Facebook while just 16% use Twitter.4 Not using social media to communicate essential updates regarding the COVID-19 outbreak is a missed opportunity.
Local health departments should routinely communicate and engage with their audiences on social media and provide situational awareness on the outbreak by posting accurate and timely information. When communicating COVID-19 messaging with the public, communicators should provide evidence-based information to back their claims and consult with subject matter experts first.5 Providing false or misleading information could result in distrust from the public.
Building Capacity for COVID-19 Social Media Emergency Communications and Strategy Recommendations
It is paramount for LHDs to build in-house capacity so that they can frequently communicate important COVID-19 updates with the public, effectively use social networking platforms and mobile technologies, and engage audiences. Designated LHD staff should be trained to manage their agency's social media platforms, respond to COVID-19 inquiries and comments,6 and perform social listening to gauge the attitudes of the community. When building an online presence, communications staff should consider hard-to-reach populations such as non–English speakers and people with disabilities. In doing this, communications staff can make posts in different languages and create graphics that are Section 508 compliant. Because the public has a high level of trust for public health experts' response to COVID-19,7 it is likely that online searches for health departments have increased. As such, LHDs should ensure their social media channels and Web site are easy to search for and find. In addition, over the past several years, LHDs have had to contend with limited funding and a lack of resources. Local health departments with limited resources should collaborate with partners with a large social media presence to amplify COVID-19 messaging.
NACCHO's Social Media Toolkit: A Primer for Local Health Department PIOs and Communications Professionals includes additional information on how to integrate social media to emergency communications plans, monitor and manage misinformation, and includes best practices for posting content.8 The tool kit also includes information on emergency management virtual operations support teams (VOSTs). These digital teams are groups of volunteers that provide online support to agencies that have limited or no resources. VOSTs typically manage an agency's social media channels during an emergency and assist public health officials in amplifying important crisis communications.8
Combatting COVID-19 Misinformation
While advancements in technology have made it easy to access and share information, LHDs face a new challenge—combatting public health misinformation. Since the start of 2020, COVID-19 has dominated news cycles nationwide. Unfortunately, with an increase in news surrounding the virus came an increase in misinformation. False or unfounded information about COVID-19 can seriously impede response efforts. According to a survey conducted by the Pew Research Center, 8 out of 10 consumers of social media news say they have been following news of the outbreak fairly closely—with a majority of those consumers being exposed to some misinformation about coronavirus.9 In addition, 48% of adults in the United States say they have been exposed to false information about the virus.10
In communicating critical COVID-19 information, the public tends to lean on trusted sources. A March 2020 poll from NPR/PBS NewsHour/Marist found that 84% of Americans trust coronavirus information from public health experts, while results from a March 2020 survey conducted by the Pew Research Center show that nearly 79% of US adults believe public health officials are doing an excellent or good job at responding to the coronavirus outbreak.7,11 Local health departments can leverage their trustworthiness to dispel COVID-19 rumors by providing accurate, evidence-based information.
NACCHO's COVID-19 Risk Communications Activities
The COVID-19 pandemic has led to the development and updating of risk communications, guidelines, and tool kits across the country. NACCHO is no exception. To support LHD response efforts and maintain situational awareness, NACCHO activated level 3 of its COVID-19 Incident Command Structure. In doing this, NACCHO has developed an external-facing COVID-19 Web site for visitors to learn more about NACCHO's response activities, as well as to find official resources, press statements, news coverage, and other COVID-19–related materials. NACCHO's goal was 3-fold: facilitate access to resources and best practices to LHDs, communicate the value and role of LHDs to policy makers and the general public, and provide fact-based COVID-19–related information to the general public.
NACCHO set up a COVID-19 Virtual Community site, where LHDs can share best practices and learn what others are doing to respond to the outbreak. Weekly calls with NACCHO workgroups and periodic calls with local health officials were instituted to gain feedback on response efforts. In addition, NACCHO began a weekly “COVID-19 News and Resources” blog to facilitate constant sharing of information and guidance.
NACCHO also launched an online form to collect information and stories from LHDs about their preparedness and response efforts to COVID-19. This was developed as a way to highlight the critical role of LHDs through media outreach, advocacy, and stakeholder engagement.
NACCHO's social media feeds are frequently monitored and managed by communications team members. With approximately 22 500 followers on Twitter and 5500 followers on Facebook, social media is one of NACCHO's main sources for communicating COVID-19 messaging.
NACCHO Recommendations for Risk Communications Capacity
NACCHO encourages the building and enhancement of crisis and emergency risk communications for LHDs. NACCHO's policy statement on risk communications capacity provides recommendations that aim to help LHDs communicate with stakeholders and community members during public health emergencies. Those recommendations include the following:
- Prioritize risk communications capacity. Development of risk communications capacity and sustainability should be a top priority for LHD leadership. In doing so, LHDs can best protect their communities before, during, and after public health emergencies.
- Have a trained and experienced communications professional on staff. Local health departments should have a least one designated communicator or public information officer on staff. These professionals should be well versed in risk communications best practices, know how to work with the media, be able to effectively use multiple communications and social media channels, and possess knowledge of health marketing.
- Consider the Centers' for Disease Control and Prevention (CDC's) Public Health Emergency Preparedness Capability 4: Emergency Public Information and Warning. Within this capability, it is suggested that LHDs be able to activate an emergency public health information system; decide whether there is a need for collaboration on public information systems; develop and engage in information system operations; create ways for the public to interact and exchange information; and disseminate information and alerts.
- Consult CDC's Public Health Emergency Preparedness Capability 6: Information Sharing. Within this capability, LHDs should be able to recognize which stakeholders should be integrated into information flows; establish guidelines and data elements for information exchanges; and share information to determine common operations.
- Develop a coordinated approach to disseminating messages to the public. Internal coordination among LHD staff members is important when developing cohesive messaging for the public. Local health departments should use a preexisting organizational structure or develop one to coordinate the release of uniform messaging.
- Take a community approach. Local health departments should be reaching their entire communities, including vulnerable populations. Communicators should possess multicultural awareness competencies and know the most effective tools for reaching various communities.12
Although LHDs should continue looking toward effective and innovative ways to communicate to the public, it is important to continue using traditional methods of spreading information, such as press releases, public service announcements, and phone calls. Risk communications is essential, not just for COVID-19 messaging but also for all public health emergencies. Developing the capacity to establish and sustain emergency and risk communications plans can help LHDs better mitigate confusion, widely distribute vital information, and protect communities.
1. World Health Organization. Risk communication and community engagement readiness and response to coronavirus disease (COVID-19). https://www.who.int/publications-detail/risk-communication-and-community-engagement-readiness-and-initial-response-for-novel-coronaviruses-(-ncov)
. Published 2020. Accessed April 5, 2020.
2. Institute of Medicine. Research Priorities in Emergency Preparedness and Response for Public Health Systems: A Letter Report. Washington, DC: The National Academies Press; 2008. https://doi.org/10.17226/12136
. Accessed March 27, 2020.
3. Pew Research Center. News use across social media platforms 2017. http://www.journalism.org/2017/09/07/news-use-across-social-media-platforms-2017
. Published September 2017. Accessed April 5, 2020.
4. National Association of County and City Health Officials. 2016 National Profile of Local Health Departments. https://nacchovoice.naccho.org/2017/01/25/2016-national-profile-of-local-health-departments/
. Published January 2016. Accessed March 29, 2020.
5. Centers for Disease Control and Prevention Office of Public Health Preparedness and Response. CERC in an infectious disease outbreak. https://emergency.cdc.gov/cerc/resources/pdf/315829-A_FS_CERC_Infectious_Disease.pdf
. Accessed April 5, 2020.
6. National Association of County and City Health Officials. Social media for emergency and risk communications. https://www.naccho.org/uploads/downloadable-resources/14-10-Social-Media-for-Emergency-and-Risk-Communications.pdf
. Published March 2018. Accessed March 25, 2020.
7. Pew Research Center. Polling shows signs of public trust in institutions amid the pandemic. https://www.pewresearch.org/science/2020/04/07/polling-shows-signs-of-public-trust-in-institutions-amid-pandemic/
. Published April 2020. Accessed April 9, 2020.
8. National Association of County and City Health Officials. Social media toolkit: a primer for local health department PIOs and communications professionals. https://bit.ly/2RzuFpq
. Published July 2019. Accessed March 30, 2020.
9. Pew Research Center. Americans who primarily get news through social media are least likely to follow COVID-19 coverage, most likely to report seeing made-up news. https://www.journalism.org/2020/03/25/americans-who-primarily-get-news-through-social-media-are-least-likely-to-follow-covid-19-coverage-most-likely-to-report-seeing-made-up-news/
. Published March 2020. Accessed April 9, 2020.
10. Pew Research Center. Americans immersed in COVID-19 news; most think media are doing fairly well covering it. https://www.journalism.org/2020/03/18/americans-immersed-in-covid-19-news-most-think-media-are-doing-fairly-well-covering-it/
. Published March 2020. Accessed April 9, 2020.
11. NPR. Poll: Americans don't trust what they're hearing from Trump on coronavirus. https://www.npr.org/2020/03/17/816680033/poll-americans-dont-trust-what-they-re-hearing-from-trump-on-coronavirus
. Published March 2020. Accessed March 30, 2020.
12. National Association of County and City Health Officials. Risk communication capacity. https://www.naccho.org/uploads/downloadable-resources/15-08-Risk-Communication-Capacity.pdf
. Published November 2015. Accessed March 27, 2020.