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A growing problem in public health is getting people to heed advice


People are beyond weary of the pandemic, and many are tuning out public health messages. This even as the omicron variant wreaks havoc on hospitals and kills more than 1,500 Americans every day. One of the growing problems in public health right now is getting people to heed advice at all. NPR's Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: Jeff Fortenbacher is CEO of Access Health. It's a nonprofit offering discounted health insurance and health counseling to disadvantaged patients in Muskegon, Mich. Among the poor and minority populations there, a mere 14% of people are fully vaccinated. Fortenbacher says they don't get good information on health in general.

JEFF FORTENBACHER: It just cuts across that whole issue of trust and suspicion and just not getting the information.

NOGUCHI: That problem is only getting worse. Fortenbacher says after two years of masks, isolation travel and vaccine recommendations, many are just checked out.

FORTENBACHER: I mean, it's almost like white noise.

NOGUCHI: Like recently, when the CDC changed its isolation guidelines. That sowed still more confusion.

FORTENBACHER: It's just become very draining, emotionally draining. It's very politicized, and people are just kind of - they're getting tired.

NOGUCHI: As in many other areas, Muskegon's COVID caseloads are climbing. Those who are fully vaccinated are far less likely to die or get hospitalized. But the fact that vaccinated people are getting infected at all, Fortenbacher says, seems to contradict a common but inaccurate notion that COVID vaccines block infections.

FORTENBACHER: So I think that's confusing for people, is that initial message was that if you get the vaccine, you're going to be OK. So then they go, wait a minute. If we're supposed to get it because this is what it was supposed to do, and it's not doing that, why should I do it?

NOGUCHI: Public health advocates acknowledge fewer people are paying attention or heeding expert advice. Many, including White House officials, concede they're now adapting their messages to the realities of a population with a waning appetite for warnings and mandates. For Fortenbacher, that means recommending but not mandating masks, even in clinics. A requirement, he says, would likely undercut their health goals by alienating some patients.

FORTENBACHER: If you're requiring them to mask up, you aren't going to accomplish what you need to accomplish with them because you aren't going to engage them because they're going to be so pissed off. It's really kind of just walking that line.

NOGUCHI: That comes with risks, too. Namely, it could prolong the pandemic.

ADRIANE CASALOTTI: They might be done with the pandemic. The pandemic's not done with them.

NOGUCHI: Adriane Casalotti heads government affairs for the National Association of City and County Health Officials. She says people are no longer taking their calls.

CASALOTTI: They're not picking up their phone when the contact tracers call them. They are not giving information about who they've been in contact with or where they've been so that the contact tracers could follow up on that.

NOGUCHI: And that hampered that early warning system even before omicron spread. But, she says, people are still interested in what's happening in their local area.

CASALOTTI: Well, if you can talk about your county, if you can talk about your corner of a state and look at the data in that way, to be more specific about what's actually happening to your friends and neighbors - that's another way to try and bring these big conversations more to life.

NOGUCHI: Casalotti, like many others, argues that guidance needs to be simpler.

CASALOTTI: The bumper sticker version is a lot easier than the three-page version or even the three-paragraph version.

NOGUCHI: The problem is the pandemic is not simple to understand. Public health recommendations are based on evolving understanding of a new science, so messaging changes. Georges Benjamin heads the American Public Health Association.

GEORGES BENJAMIN: The challenge we always have with communication is they always say people need to hear things seven times before it really sticks.

NOGUCHI: Benjamin says because of vaccines, the world has made a lot of progress. He argues messages should focus more on possible roadmaps for the future.

BENJAMIN: There is a reluctance to give people information because we are afraid of being wrong three months from now. But I do think we have to give people a sense of hope. And we need to tell people what we anticipate going forward and how this ends.

NOGUCHI: They might tune back in, he says, if the message is about life after the pandemic.

Yuki Noguchi, NPR News. Transcript provided by NPR, Copyright NPR.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.