‘Uncertainty’ Is Indeed a Bad Word: A Second Opinion on Pandemic Communication

Olson is a communications expert.

In a MedPage Today op-ed earlier this week, the authors made a plea for the government to “communicate about [H5N1] more efficiently and effectively.” Who could disagree?

But their title opens with a dogmatic statement, “Uncertainty Isn’t a Bad Word,” and the piece calls for our federal agencies to “communicate what they don’t know as clearly as what they do know.”

This may hold true for enlightened academics, but when it comes to the general public, uncertainty is somewhere between delicate and dangerous cargo. Uncertainty is indeed a bad word for mass communication when it’s not handled properly.

Humans communicate through a set of core principles that are identical for all disciplines. For the most part there is no “science communication” any more than there is “economic communication” or even “Hollywood communication.” There is just communication of information in general. For every discipline, information is presented and argued according to basic principles that are thousands of years old.

Ideally three things are presented: First, a context is established. Then a problem is identified, and then the actions to solve it are presented.

One of the core consequences of this dynamic is that there are two basic audiences — those who already know the topic, and those who do not. In the work my group has done training scientists in communication, we have developed an extremely simple yet powerful diagram to convey this divide:

Credit: Olson

The inner circle is everyone who knows the topic well. These people do indeed find uncertainty interesting and fascinating. But how big is the inner circle for any topic? For epidemiology, how many people really know the basic details of viruses, vaccines, and pandemics?

For everyone else who lacks a basic understanding of the topic of epidemiology generally and H5N1 specifically — which is the majority of people in America — they are in the outer circle. They need communication that is different. For them, they need a good, clear, simple set up — and when it comes to doing this, uncertainty is disastrous.

How can I be certain of this? Because if you broaden your perspective beyond the insular world of H5N1 science — beyond the world of epidemiology, and even beyond science itself — you see that the broad audience is driven by age-old narrative principles, one of which is the universal desire for what is called “the omniscient narrator.”

You can see this at work with any novel you read or movie you watch. The narrator doesn’t waffle about what we don’t know. The narrator tells you what we do know. It’s what the audience wants.

President Barack Obama conceded this in 2012 while running for a second term when he was asked what was the biggest shortcoming of his first term. He said, “The mistake of my first term — of my first couple of years — was thinking that this job was just about getting the policy right. And that’s important. But the nature of this office is also to tell a story to the American people…”

What I believe he meant by “tell a story” is to present information in a clear, three-part structure of set up, problem, solution.

This is the key to communicating more effectively and efficiently.

For a good, recent example of what I’m talking about, look no further than the recent subcommittee hearing with Anthony Fauci, MD, about the COVID pandemic origins. Most of the Democratic members of Congress who spoke fell more towards the beginning side of the Obama quote — simply stating facts, not engaging in telling a story. But Representative Kweisi Mfume (D-Md.) did a beautiful job of following the basic three-part structure of a story: beginning with the setup, presenting the problem, and then discussing the actions taken in relation to the problem.

He went right into the sort of storytelling mode that Obama likely dreamed of as Mfume said, “Let’s go back to when we were in the heart of the pandemic, when our family members and friends and co-workers were dying left and right. When we were afraid to get near anybody…”

What he is presenting there is information for which we have complete certainty. This is how you get the public to open up their ears to channels of communication. It’s not easy to craft this type of message, but it is obligatory. And yes, uncertainty can be presented, but it needs to have the proper context.

Regarding H5N1 communications, we cannot force feed the public uncertainty and expect them to like it. If we do, we will drive many to voices that do provide complete certainty — whether right or wrong (i.e., the sort of misinformation/disinformation that Fauci warned of repeatedly in his testimony).

The biomedical community needs to learn this basic tripartite structure of communication, drawing on the principles of narrative structure that are thousands of years old. The public — the members of the outer circle — desperately need this sort of set up, and the set up is crafted not out of mentioning what we do not know, but rather what we do know.

Randy Olson, PhD, is a scientist-turned-filmmaker. He is the 2020 recipient of the John P. McGovern Award for Excellence in Biomedical Communication from the American Medical Writers Association, and the author of 11 books on science communication including, Houston We Have a Narrative: Why Science Needs Story, and The Narrative Gym for Medicine.

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