- Welcome everyone to Wednesday Nite @ the Lab.
I'm Tom Zinnen.
I work at the UW-Madison Biotechnology Center.
I also work for the Division of Extension Wisconsin 4-H.
And on behalf of those folks and our other co-organizers,
PBS Wisconsin, the Wisconsin Alumni Association,
and the UW-Madison Science Alliance,
thanks again for coming to Wednesday Nite @ the Lab.
We do this every Wednesday night by Zoom,
50 times a year.
Tonight, it's my pleasure to introduce to you Malia Jones.
She's an epidemiologist
with the Applied Population Lab here at UW-Madison.
She got her undergraduate degree in anthropology
at the American University in Washington, D.C.
and then got her MPH at UCLA and her PhD also at UCLA.

She's an epidemiologist as I mentioned,
and at the beginning of the COVID epidemic,
she and several of her colleagues around the world
started the Dear Pandemic project,
which helps to provide information about the virus,
the disease, and its spread,
and also to fight misinformation about those three things.
Tonight, she'll be talking with us
about the Dear Pandemic project,
how it started, where it's going,
and how things are today.

- Thanks very much, Tom.
It's a pleasure to be back here.
And I'm excited to share with you today
this project that I have been working on
in this first year of the COVID-19 pandemic.

So I'm gonna talk to you
about this social media project called Dear Pandemic.
And the goal of the project is really to provide
curated, comprehensive, and timely information
about COVID-19 to a general audience.
And we're on social media.
We're an all-female, interdisciplinary team
of scientists and clinicians, and we espouse the core values
of kindness, transparency, and scientific rigor.
And we're trying to do that
on Facebook, Twitter, and Instagram,
and it's been really an adventure.
So I hope you enjoy.
I'm gonna start off a bit about,
with a bit about an introduction,
and then I'll turn to a section
that's about our mission, which is to help people navigate
the overwhelming amount of information
that's available, flying around social media
during the COVID-19 pandemic.
And finally, I'll talk about some of the big lessons learned
from having done this work
over this first year of the pandemic.
So just to start off with a little bit about me.
My name's Malia Jones, as Tom said.
I have a PhD and a master's in public health from UCLA.
My training is in epidemiology and community health.
I also have training in demography and geography,
and I am currently an Associate Scientist
at the UW-Madison Applied Population Laboratory.

I study how infectious diseases spread
through groups of people.
And before the pandemic,
I mostly studied how vaccine hesitancy,
especially for childhood vaccinations,
can undermine herd immunity.
And particularly when groups of people
who don't wanna get vaccines
tend to cluster in schools and certain neighborhoods.
And so at the beginning of the COVID-19 pandemic
in February and March of 2020, I was sort of positioned
in this adjacent scientific field.
And I started getting a lot of questions
from my friends and family members.
In late February, I was actually on vacation in Iceland

on a lovely vacation with my husband,
and I could see what was happening
in Italy and in the U.K., in South Korea and Iran,
and could see that we really had a pandemic on our hands.

I thought at that time that I knew what would happen next.
I imagined that we would be going
into social distancing and you know,
having quote-unquote lockdowns.
And I don't really think I had a clear picture
of what that would look like.
I, in Iceland, bought tons of yarn,
which you can see my yarn collection right here,
imagining that I would have all this spare time to knit
and do lots of homey projects.
But instead, I got pulled in
to the world of science communications
at a time when that was badly needed.
So I was fielding all these questions
from my colleagues and friends, family members, and the media.
And I was really overwhelmed
with the amount of, the number of requests.
So I reached out to my longtime collaborator,
Dr. Alison Buttenheim, who is a professor at Penn
and also studies vaccine hesitancy
from a behavioral science perspective.
She was also getting a lot of inquiries
and struggling to keep up.
And so together, we decided to consolidate our efforts
and put some information out on social media about the pandemic.

I'll talk a little bit more
about these project origins and the timeline
'cause it all did happen very quickly
right at the beginning of the pandemic.
In February, as you probably remember,
the first cases were confirmed in the United States.
Just a couple of days later, Dr. Buttenheim was asked
to manage the COVID inquiries that were coming in
for the Penn University School of Nursing.

On March 4th, 2020, the CDC acknowledged
for the first time that person-to-person transmission
was happening in the United States.
And they relaxed their guidelines
for who could and should be tested for COVID-19.
And that was really a turning point.
The first time the CDC was acknowledging
that this was happening inside the United States.
The next day, I sent an email to my friends and family members

just describing in very practical terms
what I saw happening, what I expected to happen next,
and that email quickly got picked up on social media.
It went viral on Facebook and Twitter.

I knew I was in, I knew I was becoming famous
when my credentials were called into question on Reddit.
And it was really a wild ride from there.
The next week, that email was picked up by USA Today
and printed in their weekend edition as an op-ed,

and seen by, I'm told, millions of people.

A couple days later, Dr. Buttenheim
launched the Dear Pandemic idea on Instagram
after we talked about collaborating.

The next day, I taped a interview for Dr. Phil,

what is probably my only lifetime appearance on Dr. Phil.
And a few days after that,
the Dear Pandemic project was launched
on Facebook and Twitter.
And we have been on social media sites
for the last, nearly a year.
So far, we have almost 900 posts
about all kinds of pandemic-related topics.

So as part of this effort,
and as part of the more general pandemic response,
I think it's really important to communicate the differences
and the overlap between medicine and population health.
Public health really refers to the study and practice
of keeping groups of people healthy
by doing things that affect everyone.
Like for example, improving the quality of water
to keep everyone safe with clean drinking water,
making sure that restaurants have to stay clean,
making it harder to buy cigarettes, for example,
by increasing the price of cigarettes,
and by making it required to wear masks,
which has been a major topic
in the last year in the pandemic.
Now this is quite different from medicine,
which is the study and practice of promoting health
in one single person at a time.
And one of the real challenges has been
that a pandemic is inherently a population problem,
but it requires individual people
to cooperate and change their behavior
in ways that are sometimes
very inconvenient and uncomfortable
in order to manage the ongoing outbreak.
And so this has been the real challenge
of public health over this last year,
as we've tried to get a grip on the COVID-19 pandemic.
My training is in public health,
but the team of women who contribute to Dear Pandemic
includes many other disciplines.
We have 12 core doctorally-trained contributors
across many areas of scientific expertise.
These include clinicians and researchers like myself,
and we have expertise in epidemiology,
gerontology, family medicine, mental health,
economics, nursing practice.
We have a medical doctor on the team
as well as 11 PhD-trained contributors.
We also have one core coordinator
who is, her name is Gretchen Peterson.
She is the COO of our operation.
She's a retired middle school teacher
who fortunately for us,
was looking for a retirement volunteer job.
And she really is the glue that holds our team together.
We also have several other PhD-trained regular writers
and interns and volunteers.

Our mission is to educate and empower people
to navigate the overwhelming amount of information
circulating during the COVID-19 pandemic.

And we achieve that mission by using some guiding principles.

Those are, first, we take an interdisciplinary approach.
We really believe it takes more than just MDs
and more than just epidemiologists
to defeat a pandemic.
And so we are a very collaborative,
interdisciplinary team.

We also use a harm reduction model,
and this is just the idea that a little better
is a little bit better.
If we all modify our behaviors in small ways,
in ways that are manageable, then we can obtain,
we can reach some positive impact
on the population health and in this case,
specifically the spread of COVID-19 in the population.
So we really go out of our way to not require perfection,

ask people to do what they can do
and do it as well as they can.
And we have this focus that I'm gonna return to,
which is that there's no such thing
as being safe in a pandemic.
It's an inherently unsafe situation,
but we can make it a little safer.

We also believe the infodemic is as real as the pandemic.
And I will return to that word infodemic in just a minute.
We see policy and science as a partnership, not a war.
And even though many of the contributors
have strong political views,
we really try and keep partisan politics out of our posts
and try to heal the chasm that has developed
over this past year between science and policy.

We also believe in lifting up the voices
of women in science.
Early on in the pandemic we,
many of us noticed that a lot of the voices
that were being heard the loudest
in the news media were men,
and the truth is, public health is a mostly female profession.
And so we really committed ourselves
to this idea of collaboration
and cooperation to lift up the voices of female scientists.

And finally, we really believe
in the power of the personal connection.
We're doing this work on social media.
We interact directly with our readers.
We actively solicit questions and provide answers with them.
And this has been a very different model
for how to do science and science communication.
It's not at all the traditional public health model.
And it's been really rewarding
and has resulted in some lessons learned.

So the project itself is, as I said,
it's a social media-based project.
We are on Facebook in both English and Spanish.
We're also on Twitter and Instagram
and we have a weekly live video show
in which we talk about
the questions our readers have asked
and provide answers for those.
All of that is housed on our website.
And you can find all of those links
on the slides that I'm providing.

So a big part of our mission,
in fact, the central part of our mission
is this idea of fighting the infodemic on its own turf.
And what does that mean?
So when we talk about the pandemic
and all of the information that's available
on the pandemic, often we get this feeling
like we're drowning in information,
and that feeling, like there's so much information
that it's impossible to sort out what's right
and what's not, is the infodemic.
WHO has defined an infodemic
as an over-abundance of information,
both online and primarily...

primarily online and offline.
And it includes both misinformation
and disinformation.
It can be really harmful to our physical and mental health
to have too much information
because it's impossible to sort through
what is correct and what are appropriate behaviors

when there's no way to decide what's right and what's not.

So it's really been our goal to equip people
to fight the infodemic in their own social networks
and also empower them to engage in healthier behaviors
during the pandemic.

There's been a call among scientists
to take up cudgels in the battle
against misinformation and disinformation.
And this has really been our inspiration,
as the team of people who contribute to Dear Pandemic
have continued to do this over the last year.
We feel it's the duty of scientists
to get involved in the fight for better information
and to fight against the infodemic
and the overwhelming amount of good
and bad information that's out there.

Disinformation expert Claire Wardle
from Harvard University in Massachusetts
has said the best way to fight misinformation
is to swamp the landscape with accurate information
that is easy to digest, engaging,
easy to share on mobile devices.
So that is what we're trying to do.
We're trying to equip our readers
with the power of the share button
to fight the infodemic.

And this is really necessary
because information flies very easily on social media.
In fact, the algorithms that social media engines use
respond better to the altitude of flight
than to anything about its quality.
So because we trust our friends
and the people who are in our social networks,
we're actually very prone
to believe the things that they say
and forward to us on social media,
and even more than the experts.
So these one-on-one exchanges
and the shares that we see on social media
are really the root of the infodemic.
It's really very easy
for misinformation, disinformation
and just too much information to fly on social media.

In addition to that,
in particular misinformation and disinformation,
it's really important for all of us to be mindful
about where our information is coming from
and where it's going because much like an infectious disease,
when we share misinformation,
it can be spread far beyond our own social networks
that we've shared it with.

So one of the things that we do on Dear Pandemic
is really try to fight this.
I'll pause to define misinformation
and disinformation.
They're just a little bit different terminology,
but I think it's important to identify,
especially in the context of the vaccine hesitancy

for COVID-19 vaccines and other vaccines.
Misinformation is the information
that's simply incorrect or just taken out of context
in a way that makes it inaccurate.
But disinformation is information
that's intentionally developed and meant to deceive us.
And usually that's for some kind of a specific political
or other form of power.

We're seeing disinformation campaigns,
especially around the COVID-19 vaccines
that do seem to be intentionally manipulating our emotions.
And that's one of the primary things
that we are trying to fight against at Dear Pandemic.

So I have a few tips for sharing better information
and checking to see if the information you're sharing
is good or bad information.
And we like to summarize this
as don't share unless you are sure.
And here are just a few ideas for how to check to see
if something is good or bad information.
The first thing to check for
is to check your emotional response.
If you find that some piece of information
flying on social media is scary, very troubling,
you know, triggers some other strong emotional response,
there's a good chance it was actually designed to do that.
And it's a very good idea to look deeper
and really check the sources on that,
any information that triggers a response like that.
It's also really important for us
to assess the source of information.

Many times, disinformation campaigns
can appear to be very legitimate sources,
but upon closer examination, turn out not to be.
We should read beyond the headlines.
I'm guilty of this, as are so many of us,
especially when we're doom scrolling late at night.
It's very easy to just look at the headline
or the short version of an article
and then decide that it's worth sharing.
But I think before we share information,
we really should dig deeper.
I have learned over the course of this past year
that the authors, even within the news media,
very rarely write the headlines.
It's usually the editors who write headlines,
and they're often written to trigger emotional responses.
Sometimes the headline is saying something
that is really not exactly what's in the article itself.

Another great tip is to identify the author.
And if possible, try to think
about the author's motivation for writing this.
I think that can go a long way to some information hygiene
and deciding if it's information that you wanna share.

Another good tip is to check the date.
The pandemic has evolved very quickly,
and even information from six months ago
can be out of date.
And so it's always a good idea to check the date
as well as the author and the source on information
you're sharing online.

And then finally, I think we should check our own biases.

If some source has really confirmed something
that you already believe,
we're very prone to that idea of confirmation bias or the,
when something that we read confirms
what we already thought,
and therefore we're even more prone
to believe it, it confirms our beliefs.
And if you do find that those, there's anything concerning
across those different fronts,
it's always a great idea to turn to fact checkers
and something as simple as just Google searching the headline
of what you wanna share along with the phrase "fact check"
can go a long way to helping us avoid
accidentally spreading misinformation
or disinformation campaigns.

At Dear Pandemic, we have actively tried
to replace bad information with good information,
and we do this by putting together articles
that answer some of the common questions about COVID-19
and some of the rumors that are flying around about it.
So I have a few examples here on the slide,
and you can see that some of the questions
that we have tackled in this vein
include things like can mRNA vaccines change my DNA?

Is there any truth that ivermectin
prevents or lessens the severity of COVID-19?
And did a recent CDC study really show
that 85% of people who wear masks get COVID?
These are all rumors that are untrue.
And what we've tried to do
is provide some factual information
that gets at the root of these rumors
and really assesses what the true story is.

We also have as one of our core goals
to not just replace the bad information
with better information,
but to directly fight the misinformation
that flies so readily on social media
by equipping our readers with the trustworthy information
and to be consumers of information.
So one of our goals is to actually build in our readers
some critical thinking skills and some science literacy
to understand how science works.
And so I'll show a few example posts in this vein.
One of them is how do I fight fake news?
And it has some tips for how to combat
when you see something that is flying
on social media that is false.
And we use the three Ds to slay information:
detect, document, and debunk
the bad information that you see.

The next example I have is a post about what's up
with the shifting scientific guidance.
One of the really frustrating things
for all of us during the last year
has been how rapidly everything seems to change.
And it seems like scientists don't know one day
and then the next day they do.

This is because science is a method,
not a fixed set of findings.
And so scientists have learned a lot
over the course of the first year of the pandemic.
And many things have changed.
Our understanding has evolved.
And so really understanding
how that scientific process works
is fundamental to understanding

some of the misinformation and disinformation claims.

And then another example I have
is a post about what are the hallmarks
of high-quality reporting?
How do we know if we do have a good source?

So we have lots more of those posts
in the fighting the infodemic vein
available on our website.

The third thing I'm gonna talk about today
is more generally, what have we learned?
What are some of the big takeaways
from having been working in this space for the last year?

The first thing I'm gonna start with is
just so we're all on the same page,
some real fundamentals about what is COVID-19.
COVID-19 is a new virus, new to human beings.
It emerged in humans sometime late in 2019
and became a pandemic by March of 2020.
The word pandemic just means it's an infectious disease
that spread all over the world on all seven continents.

COVID-19, the virus that causes it,
can cause a viral infection, which can be fatal.
It spreads moderately well from person to person.
And it usually does that through small droplets
of exhaled spit or snot,
or the fluid that is normally found inside our lungs.

COVID-19 has infected millions of people around the world.
And at the time of this recording,
has killed over half a million Americans in the United States
and many hundreds of thousands more around the world.

It causes an infection that affects the lungs
and other organs, but primarily the cause of death
is because of respiratory failure.
And of course, the pandemic has upended
all of the social, emotional, financial,
and other domains of life as the world has tried
to deal with what has truly been an historic event.

As we've been on social media,
trying to do this science communication,
one of the most common questions
that we have been getting is about risk.
We get a ton of questions
that are something along the lines as
how risky is such and such activity?
Going to the hair salon, visiting a new baby,
getting on an airplane, whatever it is.
So I really wanna talk about risk.

I think that we need a better fundamental understanding
of what risk is in order to really have these conversations.
So risk is just simply the possibility
of something bad happening.
And when we start thinking about the possibility
of something bad happening,
we can think about its likelihood,
how likely is the bad outcome?
Who is it most likely for?
What makes it more or less likely?
And can we do anything to influence how likely
the bad outcome is?
So in a pandemic, as I said before,
living in a pandemic is unsafe,
but there are some things that we can do to make it safer.
And we call those modifiable risks.

When we talk about the risks in a pandemic,
I really like to think about the risk of what.

When we think about the risk of something bad happening,
we need to know the risk of what bad thing happening.
And these come in a hierarchy in a pandemic.
The first is the risk that
you'll ever be near someone who has COVID-19.

This risk is relatively, or at least often modifiable.
And the reason that we're,
we've been asked to stay at home,
avoid large and small gatherings,
and to suppress the number of cases community-wide
is really to try to modify the risk
that we'll be near someone who has COVID-19.

Reducing cases in the community broadly
is really probably the most important thing
that we can do to stop the pandemic
and reduce everyone's risk.
Because if there aren't any cases,
then no one has any risk
that they'll be near someone with COVID-19.
So that's why there's been all this focus
on the amount of disease in the community.

Second, we have the risk that
if we are near someone who has COVID-19,
what's the risk that we'll actually catch it from them?
Not everyone who's exposed to an infected person
ends up getting COVID-19,
and those risks are also modifiable.
So by doing things like wearing a mask,
keeping six feet of physical distance
so we're out of that zone for droplets
to come out of someone else's nose or mouth as they breathe,
keeping our interactions relatively short,
and improving the air flow or ventilation
are all things that we can do to mitigate the risk that
if we do end up near someone who has COVID-19,
that we'll catch it.
Then we have the risk that if I catch COVID-19,
will I give it to someone else?
These are also modifiable risks.
And again, in this case,
the things we're asking the public to do
in order to reduce that risk is to wear a mask,
keep our physical distance, keep our interactions short,
and improve ventilation.

And then finally, we have the risk
that most people are really concerned about,
which is the risk that if I catch COVID-19,
I'll be hospitalized or die of it.
And that's very often the risk
that we're most concerned about in public health.
Unfortunately, this risk is not very modifiable,
and that's because the risk factors that lead us
to be susceptible to COVID-19 are things like our age,
our gender, our race, or our pre-existing medical conditions.
And there's just not a lot
that we can do about those risk factors.

So what can we do to make living in a pandemic safer?

There are a lot of guidelines out there,
and frankly, I find them a little bit confusing
and hard to interpret.
So we've come up with this acronym,
let's get S.M.A.R.T.
And S.M.A.R.T. stands for space, mask, air, restrict, and time.
And I'll go into a tiny bit more detail
about each of these.
And this is just a way
to organize the precautions that we can take
to make living in a pandemic a little bit safer.

Space is the idea that we should keep our physical distance,
stay at least six feet away
from people who are outside our own households.
Mask.
Everyone who can should wear a mask
over their nose and mouth.

Air.
Air flow turns out to be very important
at reducing our risk of contracting COVID-19
if we're exposed to someone,
and so we should improve the air flow
or the ventilation,
or keep our activities outside when we can.

Restrict is probably the most complicated
of the concepts to reduce, to make pandemic living safer.

And this is just, this is the idea
that we should keep the circle of people that we interact with
as small as possible, and have really good communication
with those people about their own circles of contacts
in order to prevent transmission chains
that go through whole populations.
And then finally, time.
It's important to keep our interactions
with other people short because as it turns out,
the more time you spend in contact
with someone with COVID-19,
the more of their viral particles that you can inhale
and the higher your risk of getting infected is.

This really is all dependent on this idea
of the Swiss cheese model of COVID-19 defense.
And this is the idea that
we have a lot of different measures
that can modify our risk.
None of them are entirely perfect,
but if we combine them all together,
we will get pretty good coverage
for reducing our risk of negative outcomes
or even getting COVID-19.

And finally, we were able to add, late in 2020,
one more element to the ways we can modify our COVID-19 risks.
And the moment we were all waiting for
was the release of the first COVID-19 vaccines.
And so we now talk about using all of our S.M.A.R.T.S.
and that final S being for shots,
or the idea that we should roll up our sleeves
and get our vaccine when it's our turn.

Right now, as we're recording this,
the main obstacle to getting good vaccine coverage
in the population is supply.
And I think shortly in the future,
the supply problems will be resolved
and we'll be facing problems of vaccine hesitancy
in order to get good vaccine coverage.

The vaccines are really exciting news
because it's the first thing we really have,
the first tool we really have to modify that final risk,
the risk that if we catch COVID-19,
that we'll be hospitalized or die of it.
Having been vaccinated
dramatically reduces our risk of hospitalization
and essentially eliminates our risk of death from COVID-19.
And so they're really exciting as interventions
that can change the worst of the terrible outcomes
from COVID-19 infection.

The end goal of the vaccine campaign
is to get to what's called herd immunity.

So I wanna talk a little bit about herd immunity
and how it's different from one person's immunity.
So broadly speaking, herd immunity
is the idea that if enough people
in the population are immune to an infection
or they cannot get it, then anyone who happens to have it
is just very unlikely to come into contact with someone
who might get it from them.
So the disease has a hard time finding a new host
because there's so many immune people in the population,
and then it's not passed along through the community.
Eventually, the disease will die out or at least die down
and return to just an occasional outbreak status.
This is really not the same thing
as individual level protection
that's provided by me personally getting vaccinated.

When we think about what herd immunity protects from,
we need to think about protection from what.
By getting vaccinated, I have protection
from the disease itself,
but if we have a whole lot of people vaccinated
in the population and we can reach herd immunity,
it actually provides protection to all of us,
even the people who can't be vaccinated,

perhaps because they're too young
or they have some kind of health indication
that indicates they can't get the vaccine.
For example, they're allergic to it.

This kind of herd immunity protects everyone.
And that will prevent--
it does that by preventing the outbreak itself
rather than my individual-level outcomes.
So how do we reach herd immunity for COVID-19?
Simply put, we need to have a lot of people,
in fact, most people in the population be vaccinated
and unable to transmit disease.

There's been a lot of talk.
And one of the most frustrating things
about being a scientist during this pandemic
has been the talk about herd immunity
as a strategy to manage the pandemic
in terms of just letting everybody get natural infection.

This idea emerged sometime in the middle of last year,
and really is a high-risk, high-cost proposition.
So the idea being that
if we just let everyone get exposed to COVID-19
and get infected, we can achieve herd immunity.
The truth is, no disease...
We've never achieved herd immunity for any disease
using a quote-unquote natural herd immunity strategy.
We've only ever achieved herd immunity
through vaccination.
And that's in part because we don't know how long
or how strong the immunity from natural protection really is.
In addition, COVID-19 will kill 1 in 100 people who get it.
And so just letting everyone in the population get COVID-19
comes with a tremendous cost of human life.
It really has been very frustrating
to read about people who think this is a sensible strategy
to move forward with the pandemic.

So herd immunity has to be achieved through vaccination.
And the question is how many people
do we need to have vaccinated before we can get there?
So there's a crude way to figure out
how many people that is.
And then there's a more exact way.
The crude method suggests that something like 70% of people
in the population need to be vaccinated
with a highly effective vaccine,
such as the ones we have right now

in order to reach herd immunity.
Now that 70% estimate comes from a simple calculation
that looks at how infectious the disease is.
And basically, it figures that if, on average,
each person who gets infected gives it
to around two more people,
then we need around 70% of the people to be vaccinated
in order to get to herd immunity.

As an aside, the what are called
non-pharmacological interventions,
things like wearing masks and physical distancing
actually change that value.
And so the more that we engage
in those risk mitigation measures,
the lower the temporary threshold
for herd immunity really becomes.

But the reason that we always preface this crude estimate
for herd immunity with something, you know,
we often say, "Well, it's about 70%
"or most scientists think 70%,"
is that there's actually a much more complicated way
to figure out the real threshold for herd immunity.
And in order to do that,
we need all of the relevant information.
And some of that information is at this time unknown.
Specifically, we don't know
whether the vaccines protect us from active disease
or also prevent us from ever becoming infected.

So we need to know that information.
We also need to know more information
about how the disease spreads
in typical interpersonal contexts,
contexts such as school environments,
work environments, many things that have been disrupted
and therefore really hard to observe
over the course of this first year of the pandemic.

So, as I said before, I expect that vaccine hesitancy
is ultimately going to be our main barrier
to achieving herd immunity.
We're already seeing tremendous hesitancy
around the vaccines that we have,
and by vaccine hesitancy,
I just mean people who have reservations
about getting the vaccine.

Vaccine hesitancy generally,
not just for the COVID-19 vaccines
but in general, has been identified
as one of the leading threats
to public health in the world today.
And it is currently the largest barrier
to ending the pandemic.

A few notes about vaccine hesitancy.

Vaccine hesitancy itself is not a binary outcome.
It's not an either/or.
Many people have some reservations
about vaccines and get them anyway.
Some people simply have questions about the vaccines
that they would like to be answered before they get it.
Other people have very firm beliefs
about the vaccines that will never be changed.
And so it really is more of a spectrum than an endpoint.

We also know that vaccine attitudes can change over time
and that people get their information about vaccines
from many different sources, not just their clinicians.
And those sources include social media,
friends, family, and also their clinician.

So if you are talking to a loved one
who is expressing some vaccine hesitancy,
I have a few ideas for how to have that conversation
in a way that might go smoothly
and in a way that might actually influence their decision
and help us achieve herd immunity.
So a few tips.
The first is to lead these conversations with love.
I think it's really important to tell our stories.

If you're keen to promote the vaccine to your loved ones,
you should share why you wanna promote the vaccines
to your loved ones.
For example, you might say,
"I've been so worried about you during the pandemic
"and worried about myself, too.
"I want us to be able to see each other without fear."
You can lead with this kind of love
and empathy and hearing them out on specific concerns.
Acknowledge that their worries are valid and important.

The second tip that I have is to ask questions.

We know that just throwing a whole bunch of facts
at someone is not very persuasive,
particularly if their mind is already firmly set,
but there are steps that we can take
to help friends and family access good information
and build up some resistance to the bad information.
And it's really key here to ask questions
about what their concerns are.
People have all different kinds of concerns
about getting the vaccines, and it's probably not necessary
to address each and every one of them.
So rather than try to anticipate people's concerns,
it's really important to just ask them.

Once you know what their concerns are,
you can follow up with facts that can address those concerns.

The next tip I have is to tell your own story.
We're very influenced by personal stories
and interpersonal interactions with people we love.
And so we should not underestimate the power
that we have to influence our loved ones with our own stories.
And so our excitement and our commitment
to public health are contagious, and we can be vocal
and visible about our plans to get vaccinated
and why we're motivated to do that.

So I really encourage you
if you are gonna get the vaccine, to share that news,
tell those people in your network who are hesitant
why you made the decision to do it,
and why it was important to you.

People do look to their trusted peers
to help them make these decisions.

The fourth point is to reduce friction and hassle.
We really need to make it easy
for people to get their vaccines.
And this is true for many other
health-related behaviors as well.
The smallest amount of inconvenience
or disruption can make it really hard for us
to overcome barriers and get the vaccines,
especially if people's motivation is already low.
So we know that lots of people
don't get their seasonal flu shot every year,
even when they tell us that they intend to get it
or when they don't have any specific objections
to getting the flu shot.
And so if you have people like this
in your inner circle, see what you can do
to make it as easy as possible to get vaccinated.
Help them figure out when they're eligible,
where they can go, get them to the appointment,
make a plan, and set up reminders to go.
Making it easy can go a long way
towards helping people get their vaccines.
And then finally, it's really important
to acknowledge past hurts and distrust.
Some of, for some communities in particular,
we have a history of exploitation
and unconsented experimentation,
and this has left a legacy of what's referred to
as justified mistrust in medicine.
And this is particularly true in Black, Brown,
and Native American communities in the United States.
And it's very important to allow space
for that justified mistrust and address it seriously,
and attempt to rebuild the trust in the scientific endeavor
that was really damaged by these harmful
and exploitive practices in the past.

Again, it's really important to ask questions
and hear the specific concerns of the people in your network.

People who don't trust the vaccine
may worry that the safety data
aren't adequate for their particular group.
They may be exhausted from having to deal
with all of the troubles of the pandemic.
They might just be tired of being told what to do.
And so hearing those specific concerns
and trying to address them with an open heart
really can go a long way towards convincing your loved ones
to get the vaccines.
And this also goes for other types of vaccines.
Before the pandemic, I studied vaccine hesitancy
for childhood immunizations.
And in fact, the last time I was on University Place,
that was what I was talking about.
And so vaccine hesitancy
doesn't just apply to COVID-19 vaccines.
It's actually a big problem for all of the vaccines
that we have available to protect the public health.
And so these same tips can be used
for COVID-19 vaccine promotion
and other types of vaccine hesitancy
that you're seeing around you.

So I have a few ideas about the lessons that we have learned
that maybe we can carry forward to the next pandemic
or the next global health crisis,
which I hope is a long way off for us.
The first is that we really need to foster trust
in science and in the scientific endeavor.
Somehow over the past few decades,
this trust has really been lost.
And I think it's very important
to do the sort of work that Dear Pandemic is trying to do,
which is to communicate with transparency,
empathy, and kindness, and also lead with facts
and be in the public space, talking to the general public.

Part of that is to improve scientific literacy.

A lot of the people, the readers on our page
just don't have good, fundamental scientific literacy,
and this is something that we're trying to rebuild.
And I think that it would be a really important thing
to rebuild more broadly in our education system
as we think ahead to how to face the next pandemic
with a little more ease.

The infodemic problem, the problem of social media
spreading all kinds of information, good and bad,
probably too quickly, is not going anywhere.
And so I think it is important to develop this science
of infodemeology and really understand
how information spreads on social media,
why it's attractive to us
to engage in that kind of misinformation,
anticipate another infodemic,
and figure out how to fight it on its own turf.

Another big takeaway that I have is that
we should not underestimate our own power
to influence our loved ones.
Truly, the personal connections
that we have made with readers on Dear Pandemic
have been very fundamental to the success of this project.
And I think that all of us is really in a position of power
and we need to recognize the power that we have
to influence the decisions of the people directly around us
by engaging with good information
and pushing back on bad information
with kindness and an open mind.

And then finally, I think one of the things
that academics really have struggled with
and in some cases, public health authorities
such as the CDC and public health departments
is to keep the information that we're delivering
really practical and specific.
It's very challenging for people,
unexpectedly challenging for our readers
to take general information
and apply it to their specific situation.
And so one of my big communication lessons
that I've learned is that the information that we give,
the advice we give has to be very practical
and very specific.
For example, you know,
we can talk about the need to wear masks.
And, you know, we started off at Dear Pandemic
talking about the need to wear masks
and then immediately realized
that just telling people to wear a mask
is not specific enough.
We also need to know all kinds of other tiny, little decisions
about what kind of mask, if it should have ear loops
or if it should tie around the back of the head,
if a neck gaiter is as good as a typical style mask,
when to wear them, where to wear them, how to wash them,
all kinds of practical details that also need to be answered
when we're engaging with the public
and asking them to do new behaviors.
It really has been unexpected
and a true learning experience for me, doing this work.

Dear Pandemic also focuses a lot on perspectives on health
that are not infectious disease.
And this has been really an important aspect of our work
that I would like to highlight and raise up
as we think about what public health does in the world.

Some of the perspectives on health
that are not infectious disease just stem from the fact that
our lives are all tangled up in the social changes
that have been set off by the pandemic.
And so we have talked a lot
about mental health, emotional wellness,
dealing with uncertainty as a mental health issue.
We also have all kinds of other society problems
like domestic violence, child abuse and neglect,
homelessness, the opioid crisis.

We have had all of our social connections disrupted.
We have issues with financial health,
physical activity, nutrition, education,
and gender, family, and household dynamics,
which have been really brought to the forefront
as the pandemic has emerged.
I sometimes say that no matter what particular thing
that you really care about,
the pandemic has something for you.

I think that there is a universe of scientific questions
and society-wide issues
that have been highlighted by the pandemic.
And we can use some of those lessons learned
to really improve public health
and some of these social disparities
that we see in the world going forward.

So finally, what's next for Dear Pandemic?
If you're watching this several years from now,
you may know the answer to this question when I don't.
We truly have been building this ship
as we are sailing it, and we have a few ideas
for where the project is going to go
after there is no pandemic to address.
And I hope that what we can do with it
is continue our mission
to help people fight misinformation on social media,
improve scientific literacy,
and lift up the voices of other female scientists
who are doing important work
to improve the health and well-being
of people around the world.

So I have a few links for where you can learn more.
I've put these up on the slide.
You can find all of our posts
at our website at dearpandemic.org.
And as I said, you can find us on social media,

on Facebook, Twitter, Instagram.
We're also available in Spanish on Facebook at Querida Pandemia.
And I hope this has been an enlightening hour for you.
Thanks so much for watching, and I hope to see you again.