In the Pandemic World, Science Under a Microscope: Focus on Communication and Trust.

“The single biggest problem in communication is the illusion that it has taken place.”

No scientific issue, in recent memory, has so directly affected the lives of everyone on this planet as the coronavirus (COVID-19). As such, the pandemic has placed science under the public microscope, showcasing its strengths, as well as its limitations.

On the positive side, the speed and intensity at which COVID-related research has been conducted and shared around the world has shown science at its best. The significant increase in submissions to scientific journals like JACC on topics ranging from the biology to epidemiology to therapeutics of COVID-19 highlighted the tireless work of researchers seeking to answer basic questions about the virus’s structure and mode of transmission. , Clinicians, while under great physical and emotional stress on the front lines, also gathered and shared intelligence on the impact to patients and tested treatment options.

With cardiovascular patients among those most at risk from the virus and with its members, the entire care team, being on the front lines of providing care, the American College of Cardiology (ACC) was able to quickly pivot and help translate the science and provide a forum for sharing research and best practices where research was not available. In fact, it is hard to believe that it has been nearly 2 years since the College released its first clinical bulletin addressing the cardiac implications of COVID-19 and launched its dedicated COVID-19 Hub.

Since then, the Hub has evolved and grown under the oversight of the College’s Science and Quality Committee to become the go-to source for the latest clinical and operational guidance and peer-reviewed research published in JACC Journals, as well as a place to find health policy updates, clinician well-being tools, CardioSmart patient education, and quick-tip videos on topics ranging from cardiac rehabilitation to health equity.

In addition to the Hub and robust offerings of online education, the ACC has also served as a convener for stakeholders to come together to talk about hot topics like the future of cardiovascular research and published a comprehensive health policy statement addressing “Cardiovascular Disease Considerations for COVID-19 Vaccine Prioritization.” Meanwhile, our clinical guidance work is not done, with an Expert Consensus Decision Pathway addressing topics like long COVID syndrome, return to sports after COVID, and myocarditis coming soon in the Journal.

Despite these positives, the trial-and-error nature of scientific research, as well as the need to conceive of and test hypotheses (often multiple times) to draw evidence-based conclusions have caused frustration and conflict, especially among those not familiar with the scientific process who are looking for quick answers and longer-term solutions. COVID-19 pulled back the curtain on the entire scientific process (of which many steps are traditionally overshadowed by resulting new treatments, devices, technologies, or new or revised public health guidance), and resulted in changing and sometimes conflicting health guidance related to topics like mask wearing, quarantine timelines, and business operations.

The speed and pace of research in trying to stop the spread of the virus also meant, in some cases, a sacrifice in scientific rigor, which then resulted in retractions in major media outlets and social media, but not before the findings had been shared. In today’s social media era, it was also easy for data to be oversimplified for the sake of a Twitter character count, an eye-catching headline, or even a political speech. All of this has led to clear erosion in trust of science and made maintaining clarity and credibility a challenge.

In a piece published in PEW’s Trend Magazine last year, Sudip Parikh, chief executive officer of the American Association for the Advancement of Science and executive publisher of the Science family of journals, wrote that “a scientific endeavor that is not trusted by the public cannot adequately contribute to society and will be diminished as a result.” The question then becomes: what can we do to reverse the tide and restore public faith in science?

I believe the answer lies, in part, with changing how we communicate. In general, as the field of science has advanced, it has also become more distant from regular life with the use of technical terms and language that do not fit within the parameters of a Tweet, in an image on Instagram, or in a 300- to 400-word news story in the local paper. Although technical terminology is necessary when communicating within the scientific community, this language removes science from the realm of the lay public, and, in the words of psychologist Steven Pinker, is the “curse of knowledge” and a “common cognitive blind spot.”

If we have learned nothing else from COVID-19, it is essential that scientists and even health care professionals learn how to effectively communicate the risks, benefits, and latest scientific findings beyond the academic and scientific arena. “More than ever before, how we communicate is probably as important as what we communicate—because our lives may depend on it,” wrote Junaid Nabi, senior fellow at The Aspen Institute, in a World Economic Forum blog.

Scientists and health care professionals are trusted experts, but to be effective we must learn to use clear language, avoid jargon, and incorporate empathy when communicating findings. During one of my recent “Coffee with the ACC President” discussions, Vincent Covello, MD, the founder and director of the Center for Risk Communication, stressed the importance of a message map in helping to develop a clear and concise core message that is easily understood and communicated.

Although there are several different versions, a typical message map starts with a core message at the center that is then supported by satellite statements supporting that message. Each satellite statement is then further supported by key facts, including key date points or numerical ranges, that can help inform broader conversations and messaging depending on the audience and/or the vehicle delivering the message (Figure 1 ). If done correctly, the message map can help ensure everyone is speaking with one voice and delivering the same message.

Figure 1

Communicating Science With Clarity and Credibility

Dr Covello also highlighted the importance of empathy, noting that people will not care about what you have to say unless they know you care about them. We, as clinicians and scientists, need to remember to start where our patients are and acknowledge their fears and concerns up front. We also need to be willing to acknowledge and communicate information and evidence that can change and be ambiguous at times. From there, patients are far more likely to be receptive to—and trust—our expertise and advice about the latest science.

“Research suggests that when scientists acknowledge the negative impact on people's social lives of public health interventions…people are more likely to accept them and comply,” said Nabi. This is good news, especially because public attitudes toward health care professionals are more positive than other sources like politicians and even news sources. According to a 2021 poll from the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research, roughly 7 in 10 Americans trust doctors, nurses, and pharmacists to do what is right for them and their families either most or all of the time.

“The fruits of our labor are meant to be shared broadly with our communities, not left in labs. The only way to build trust is to show members of the public that we are of them and for them, not separate from them,” says Parikh. Scientists, health care professionals, and societies like the ACC have an opportunity to shape history. There is no doubt that historians will look back on this time period and form judgments regarding the relationship between science and society. Will we be commended for the rapid development of vaccines and our quick pivot to leverage innovative technologies to allow for remote monitoring and telehealth, or will we be criticized for a breakdown in communication?

The COVID-19 pandemic will not be the last time that science will be essential to society to overcome other threats. We must make sure that when historians look back at this time of uncertainly and turmoil, they see how trust between science and society was actively strengthened and that it led to solutions that enriched our lives as well as provided lasting benefits for the public good. In the book The Demon-Haunted World: Science as a Candle in the Dark, Carl Sagan wrote, “Science is an attempt, largely successful, to understand the world, to get a grip on things, to get a hold of ourselves, to steer a safe course.” Doing this well and steering the course starts with communication, and it starts with us.