Low COVID-19 case numbers pose new challenge for public health messaging, experts say

Manitoba's streak of nearly two weeks without a new case of COVID-19 poses a new challenge for public health officials trying to urge caution, experts say.

"I think everybody in the medical research, public health communities is trying to figure out how we best message [regarding] how to remain vigilant, when we're in a community where we have zero cases," said Dr. Jason Kindrachuk, an associate professor and Canada Research chair in emerging viruses at the University of Manitoba.

On Monday, Manitoba had only one active case of COVID-19 in the province. Monday was also the province's 13th day without a new case — by far the longest streak without new cases since the pandemic began.

As he announced the news, Dr. Brent Roussin, the province's chief public health officer, warned Manitobans not to abandon pandemic precautions like physical distancing and hand hygiene.

"This virus is not done with us, and if we don't remain vigilant we'll be seeing increasing cases," Roussin said.

As active case numbers fall, public health officials now face a fresh challenge in trying to urge caution even as the public begins to relax, Kindrachuk said.

"Messaging when you're looking at increasing numbers of cases is probably easier from a public health perspective, because people are concerned," he said.

But warning the public not to celebrate too much after cases fall again?

"That's a little bit more difficult, and I think it has to be a little bit more nuanced of an approach," Kindrachuk said.

Transparency, communication key

Public health officials and commentators must walk a fine line of being cautious without appearing to be "doom and gloom," said Cynthia Carr, a Winnipeg-based epidemiologist and founder of EPI Research Inc.

Public health's role has changed since the start of the pandemic, she said, from one of education and "onboarding" — telling people what COVID-19 is, what its symptoms are and where to get tested, for example — to communicating the rules of reopening and reminders about safety.

"The main thing for [messaging] is to keep it on the radar over this summer," Carr said.

"[Remind people] the main components of stopping the spread are social distancing, hand hygiene and possibly masks if needed."

Kindrachuk and Carr both stressed the importance of transparency from public health officials about what we know — and don't know — about COVID-19 in the community.

"We want to be honest and forthright and say because of the behaviour of the public, [that's] why we are where we are, not because there's been any massive cure on the science side," Carr said. "We have to keep working together to keep the positive approach."

That includes being upfront about the limitations in how much we can really predict what's going to happen next.

"Being able to [have] that frankness with the public in saying that we are not the kind of the soothsayers in this," Kindrachuk said. "We're learning what this virus is as we go along, and trying to make decisions based on the information that we have."

Build on success

On Monday, Roussin said the province has heard more reports in recent weeks of Manitobans failing to physically distance at indoor and outdoor gatherings.

Kindrachuk said he wasn't surprised. His sense is many in the province feel they've been "granted a reprieve," as summer settles in and cases fall away.

Even surging cases south of the border could serve to desensitize people to large numbers of new cases, he said.

Kindrachuk and Carr both said they're proud of Manitobans' success so far, and hope the same discipline will help the province in the future.

"Let's celebrate our success, but let's not stop," Carr said. "Let's build on it and continue."