Ambiguous public health messages hurt the public

New York – Public health messages addressed to the general population should be clear and unambiguous. This is particularly important in times of a pandemic like COVID-19, when millions of lives are at stake. The message of “social distancing” used by public health authorities is a perfect example. It should be replaced by “physical distancing.”

“Language that is unclear — or worse, that conveys inadvertent and counterproductive meanings — undermines public health discourse. This is as true in public health as anywhere; successful behavior-change efforts, like those crucial to defeating COVID-19, depend in part on accurate, compelling language,” wrote Joanne Silberner and Howard Frumkin in The British Medical Journal.

One of the most serious effects of the coronavirus pandemic has been on people’s mental health. Children have increased sadness and depression. They also have difficulties with concentration and attention and avoid activities and games they enjoyed in the past, particularly when they are unable to be with their friends.

Many people have experienced symptoms of anxiety, fear, and depression that have even led some to hurt themselves and others. Rates of suicide have increased in the United States. In many countries, there has been significant increase in incidents of domestic violence. Among adults, the seriousness of the situation is aggravated when people are unable to work or to find jobs. For many low-income adults, the threat of eviction and homelessness is a heavy burden.

The amount of poor homeless people in New York and other big cities as a result of the pandemic is staggering. Unless new measures are place into effect, social services will be unable to deal with this situation leading to serious social repercussions.

Elderly people are more prone to get sick with COVID-19 both as a result of having weaker immune systems and more frequently underlying health conditions. Because elderly people often depend on younger family members for their daily needs, isolation measures can critically damage a family support system. Those elderly with physical or mental disabilities need increased attention and care.

In these situations, asking people to do “social distancing” is an ambiguous message that can be misinterpreted. What is needed is more intense social connection, albeit done by telephone or through social media. In this regard, the government through its public health authorities should provide specific recommendations for more effective social connectivity.

Increasingly, public health experts are calling for people to do “interpersonal physical distancing” or, in brief, “physical distancing” to avoid becoming infected by the virus. Dr. Orlando García, a psychiatrist, insists about the importance of “physical distancing” and “emotional closeness” in these critical times.

Public health experts are warning that measures such as testing and contact tracing are losing effectiveness given the speed of transmission of the pandemic. It is now particularly necessary to change the words “social distancing” to “physical distancing” and insist on the importance of increasing social connection among people to alleviate the mental health effects of the pandemic, and prevent the transmission of the infection.

“Careful solidarity with neighbors, friends, colleagues and schoolmates needs to be developed as much as possible; words also convey hugs,” says Argentine psychiatrist María de los Angeles Lopez Geist. Being human means staying connected.

I am reminded of the words of John Berryman in his poem “Homage to Mistress Bradstreet”:

“We are on each other’s hands who care”

Cesar Chelala is a medical doctor and international public health consultant.