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Communicating Public Health Guidance to Cases and Contacts: Recommendations for COVID-19 Case Investigators and Contact Tracers

May 12, 2022

Introduction

The COVID-19 pandemic has devastated communities both in the United States and abroad. The fear, uncertainty, and trauma caused by the pandemic also affect how individuals interpret public health messages. It is important for case investigators and contact tracers to understand how this stress affects a person's ability to understand public health messages, and to tailor their communications accordingly. This brief outlines actions that case investigators and contact tracers may take to communicate effectively.

Recommendations

  • Keep the message concise: When a person is under stress, it may be difficult for them to take in large pieces of information. Keep your message simple. Avoid extensive background, jargon, or technical information.
    • Example: When describing the Omicron variant, you may choose to say, “It’s another version of the virus that causes COVID-19.” Avoid technical information such as, “Omicron has four mutations in positions 142-145 that fall within the NTD-Antigenic Supersite.”
  • Repeat the main message: Stress may produce anxiety, which could cause someone to forget your message. Repeating the main message can ensure that the person remembers what you are trying to convey. Ask yourself: what is it that the case or contact needs to know?
    • Example: If you’re informing the contact that they should get tested if they develop symptoms, try repeating this statement in the beginning, middle, and end of your conversation.
  • Provide 3-4 action steps: Under normal circumstances, individuals only remember 3-7 pieces of information at a time. However, when under stress, people are often able to remember as few as three simple directions (i.e., “stop, drop, and roll” are directions often used for a fire response). Try to summarize public health guidance in 3-4 simple action steps.
    • Example: When providing quarantine instructions to a contact, you may choose to say, “Stay home, wear a mask around others, and get tested.”
  • Give positive action steps: When under stress, it is easy to forget, overlook, or confuse words like “no” or “not.” When possible, frame action steps in a positive way.
    • Example: Instead of telling someone, “Don’t leave the house without a mask,” consider saying, “Wear a mask when you leave the house.”
  • Use personal pronouns: When communicating guidance on behalf of public health agencies, it may be helpful to use personal pronouns to improve the message’s credibility and cohesion.
    • Example: This may include statements like, “We are committed to ensuring you stay as healthy as possible,” or “We understand the need for additional social support services.”
  • Respect fears and perceptions: Someone’s fear or perceptions are real to that person. Don’t use condescending or judgmental phrases when reacting to someone’s fear.
    • Example: Say things like, “It’s normal to feel anxious during times like these.”
  • Give options: Giving people options allows them to make their own decisions and may make them more likely to follow guidance. Try to avoid paternalistic or prescriptive phrases.
    • Example: Let a case or contact know about the different vaccination options they have available (i.e., Moderna, Pfizer-N-Biotech, Johnson and Johnson).
  • Avoid humor: It is critical to remain sensitive to language that may offend others. Humor should be avoided when communicating during emergencies, like the COVID-19 pandemic.
    • Example: Try not to smirk or laugh when conducting a case or contact interview and avoid making jokes or exaggerated comparisons.

Conclusion

Extreme stress, such as that caused by the COVID-19 pandemic, may change how individuals interpret and respond to information they receive. Case investigators and contact tracers should keep the recommendations listed above in mind when speaking with cases and contacts—even those who may not appear to be under mental stress from COVID-19. To prepare for these sometimes difficult conversations, case investigators and contact tracers should practice these communication skills, by role playing with a colleague or running through scenarios on their own.

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