In A Crisis, Communication Matters.

For over twenty-five years, I have been a Voice and Data Network Engineer involved in all levels of Information Technology and Information Technology Management, including Business Continuity and Disaster Recovery. I have written Disaster Recovery plans, helped draft crisis communications, provided root cause analyses, and generally worked to communicate the challenges of a technology-related crisis to the non-technical stakeholders of a number of companies.

While I can only comment on the biology and pathology of the novel coronavirus COVID-19 from the perspective of a layman, I can comment on the communications from the Centers for Disease Control (CDC) from the perspective of experience and expertise. While I have never had to address a biological viral outbreak, I have dealt with several computer viral outbreaks, and the communications challenges in both types of crises are similar, even if the magnitude and scope of the crises are different.

What I see on the CDC web site and on the CDC Twitter feed is not merely disappointing, but in key regards rather distressing. The CDC, far from being an effect source of information, is putting out inaccurate information and even misinformation, compromising their utility as an information resource.

The CDC Ignores Relevant Transmission Vectors

One of the most important pieces of information the CDC needs to communicate is how the disease is spread. Yet the CDC incorrectly focuses exclusively on respiratory droplets and close person-to-person contact in both their tweets and long-form web pages on the spread of COVID-19, ito the exclusion of all other vectors.

This omission is especially glaring because there have been reports in the Chinese media about the potential for both airborne transmission and fecal-oral transmission. Some of the precautions recommended by the CDC--remaining 6 feet away from symptomatic people particularly--are rendered ineffective when viewed against the backdrop of airborne and fecal transmission. Additional precautions and protocols are needed and should be communicated.

The additional precautions are not extensive, nor are they alien to the CDC. The CDC already has generic precautions and protocols for both airborne pathogens as well as fecal transmission.

Nor would the inclusion of the additional precautions require extensive alteration to the communication texts currently being used. A simple sentence added to the existing discussion of how the disease spreads is all it would take: "There are also reports the virus can become airborne, and can be shed in the feces and excretions of the infected patient.". Since the point of this information is to communicate the necessary precautions to slow the spread of the disease, it is not necessary these reports be fully confirmed.

The CDC Is Ignoring Reports Of Longer Incubation Periods

The current CDC discussion of COVID-19 symptoms includes this paragraph:

CDC believes at this time that symptoms of 2019-nCoV may appear in as few as 2 days or as long as 14 after exposure. This is based on what has been seen previously as the incubation period of MERS viruses.

However, the latest reporting out of China indicates that longer incubation periods are possible. While those reports concede that "most" patients will have a shorter incubation period, knowing about the possibility of a longer period allows people to take proper precautions to limit their exposures to possibly infected people, and, for the potentially infected, to limit their contact with non-infected people so as to not spread the disease. A quarantine period of 14 days will not be an effective safeguard if the disease presents after day 15.

By failing to note the longer incubation periods, the CDC is egregiously understating the risks to the general public of this disease.

The CDC Gets The Origin Of The Disease Wrong STILL

This is how the CDC describes the origin of COVID-19:

Early on, many of the patients in the outbreak of respiratory illness caused by 2019-nCov in Wuhan, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Chinese officials report that sustained person-to-person spread in the community is occurring in China. Person-to-person spread has been reported outside China, including in the United States and other countries. In addition, cases asymptomatic spread of the virus have been reported. Learn what is known about the spread of newly emerged coronaviruses.

This is inaccurate, and has known to be inaccurate for quite some time. On January 25, the South China Morning Post ran a story indicating that Patient Zero (the first person known to be infected) not only had no contact with the live animal market in question, but had been infected earlier than first realized--December 1 as opposed to late December. This story also was one of the earliest mentions of the possibility of airborne transmission.

In order to properly assess the severity of the disease, people need to have an accurate idea of how the disease arose among humans. It is this sort of information that arms people against the snake-oil salesmen peddling fake "cures" and conspiracy theorists promoting illogical and factually false depictions of what the disease is. It is this sort of information that can either bolster confidence in the CDC's updates by demonstrating attention to detail or undermine them by demonstrable inaccuracy. Yet the CDC to this day is giving factually false narrative of the disease' origin, thus undermining the quality of its own materials.

As with transmission vectors, a simple revision to the above paragraph is all that is needed. Instead of putting the person-to-person transmission events after apparent emergence in the "wet" market, clearly stating that Patient Zero did not have any known contact with that market is all that is needed. Instead of saying "Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread." the CDC could have rewritten that paragraph to say "Later reports indicate the first cases of the disease had no known contact with the market, indicating the disease may have been brought into the market by another human rather than an animal host". During the initial period of any crisis, information is inherently fluid and subject to change as new facts become known--the CDC is allowed and should be expected to revise its briefings on the disease as information arises.

People Need Complete Information

The worst sort of misinformation is partial information. Inaccurate information can easily be corrected, but incomplete information allows human imagination to "fill in the gaps" with speculation, which is not so easily corrected later. Worse, incomplete information allows speculation to appear factual, giving it greater credibility than is warranted.

In crisis communications, getting complete information out in a form that is compact and easily absorbed by a lay public is challenging. This is true in every crisis, not just epidemics. Yet it is necessary. It is the essential purpose of crisis communications.

The CDC has a responsibility to circulate the most complete information it can, and to include all the key details it can. It has a duty to update its communications with information as it becomes available, to allow people the best opportunity to assess their own risks and exposures to COVID-19.

Unfortunately, the CDC is not meeting that responsibility. Instead of putting out complete information, it is putting out misinformation.