As we approach 2 years of COVID-19, US pandemic messaging has settled into some counterproductive patterns. I want to address eight of these risk communication mistakes that public health officials and experts keep making. Turning them around can rebuild trust and help save lives.

In August 2020, CIDRAP published my commentary titled, "Public health's share of the blame: US COVID-19 risk communication failures." I tracked what I saw—and still see—as a series of missteps by public health officials in the early months of the pandemic:

Over-reassuring the public
Panicking and overreacting
Flubbing the rationale for lockdowns
Abandoning "flatten the curve"
Insisting that public health should be in charge

Except for misstep 5, which is still super important, this list of risk communication mistakes now reads like ancient history. It's hard to remember back that far.

I have produced updated lists from time to time (see this one from March 2021, for example). The most recent was a Nov 15, 2021, Zoom presentation to the Minnesota Department of Health that spurred this commentary.

The eight risk communication mistakes in this commentary aren’t necessarily the biggest challenges public health officials and experts face—maybe not even their biggest risk communication challenges. But they are likely to be among the most remediable of their risk communication challenges, since they stem from their own behavior. I think these mistakes keep happening, they do real damage, but they can be remedied—so revisiting them isn't just backward-looking.

One of the most stunning surprises of the COVID pandemic has been the growing importance of trust—or, rather, mistrust. A sizable slice of the American public has come to mistrust the public health establishment and the pandemic responses it recommends.

It has long been a truism for me that when low trust is a problem, we should focus on our own behavior: "They don't trust us" is a less useful starting point than "We're not earning their trust." I think these eight risk communication mistakes are a big piece of how US public health has forfeited some trust.