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This Isn't Working

Updated: Mar 21, 2021

I’m watching the growth of the second wave of this pandemic with horror. Public health officials are asking people to change their behaviour, but government attempts to encourage behaviour change are obviously not working.

Wisdom says if an approach isn’t effective, the solution is to change the approach. It is time to truly be innovative and look beyond these (failed) public health strategies. Innovation happens when you look outside your own narrow field.

I spoke to my brilliant friend and colleague Jennifer Gallivan recently. She shared with me the concept of E’s from the world of safety and injury prevention.

The Five E’s is a way to look at public safety campaigns through Education, Engineering and Enforcement, Encouragement and Evaluation.

Jennifer explained this to me as all great communicators do. She used plain language to draw upon a simple metaphor to explain the E’s.

She said think about safety while driving a car – there are commercials discouraging speeding (Education), speeding warnings that can be programmed in cars (Engineering), and law enforcement giving out speeding tickets (Enforcement). Encouragement can come in the form of parents reminding their teenagers to drive safely. And Evaluation is important to understand what is working and what is not, and most importantly, to adjust strategies based on learnings from evaluation results.

The most effective campaigns use a combination of the E’s. In Canada, governments are continuing to use education that isn’t working anymore, half-ass engineering safety measures some of the time, and rare enforcement that has been mostly offloaded onto individuals. Is this all being evaluated? I don’t know. Out of the five E’s, the only one doing the heavy lifting is encouragement. Encouragement is not enough.

1. Education

Education during a pandemic is health communications. The public health messaging in the spring was pretty effective: we listened to our public health officials (even elevated them to hero status in British Columbia), stayed home, washed our hands and kept away from each other.

Over the summer, people stopped listening to the messages. If I was working in public health communications, I would suggest that it is time for the messaging to change because it isn’t being effective. People have become numb to all the numbers and graphs and stopped changing their behaviour. This was in a desperate attempt to go back to ‘normal’ as we hit the six-month pandemic fatigue.

I’ll keep saying this until the day I die, what we need now are stories. STAT. If people aren’t being educated by the cold, routine announcement of numbers every day by our public health officials, they might just wake up to stories.

Here’s how you craft stories about how COVID, based on my old junior high learnings of how to write a story: Who is getting sick? What are their experiences of being sick? When did they get sick? Why did they get COVID? Where do they live?

Stop hiding behind the excuse of patient confidentiality. Anonymize stories or even better, engage real patients and families to see if they want to share their own damn stories. People are numb to numbers and educating by reciting statistics is not working anymore.

2. Engineering

Closing schools, restaurants, bars in the spring was a form of engineering safety. Slowly, this has eroded away over the past few months.

All that’s left are the remnants of lines on the floors in the grocery stores. Schools have reopened. People are dining indoors. Public employees are encouraged to go back to the office. The government has stopped engineering safety in the midst of the second wave of a pandemic.

It is shocking that governments have handed off the responsibility to engineer safety for its citizens to corporations, teachers and individuals. This is not working and causes inconsistencies and confusion. We are still in a pandemic. We need governments step up, to take care of us and help keep us safe. People are obviously not changing their behaviour on their own.

3. Enforcement

In my province of British Columbia, the governments refuses to mandate much. Forget about enforcement. We don’t even have an indoor mask mandate.

Corporations like Starbucks are doing a better job of mandating safety than our government is. This is partly because BC is in the middle of a provincial election and our Ministers are all busy campaigning.

Enforcement is rare – and it is unfairly offloaded to the waitstaff in restaurants or cashiers in the grocery store.

4. Encouragement

Dr. Bonnie Henry’s Be Safe, Be Kind, Be Calm mantra isn’t education, engineering or enforcement. It is encouragement. Believe me, I’m a proponent of kindness in health care, so I believe in this sentiment. But our officials are relying on this little slogan of encouragement to take the place of Education, Engineering, Enforcement and Evaluation. Encouragement is a small piece of a much bigger puzzle and it has been given way too much weight. It’s not working anymore.

5. Evaluation

Is this public health strategy achieving the desired results? Well, looking at the numbers of people getting sick and dying from COVID, I’d say no. Is the approach by public health officials being evaluated? I don’t know because they don’t tell us. The idea behind evaluation is that you discover what’s working and what’s not. If something isn’t working, you change it.

Even if I just look at the numbers, it obvious that our government’s strategy to handle the pandemic is not working. Unless something changes, we are going to end up with a much much worse result than we currently have. As Dr. Jill Horton said eloquently back in August: Repeat After Me. This is an Emergency.

What we are doing is not working to stem the tide of the pandemic. While I’m waiting for my government to wake up, I’ve turned away from the macro to focus on my own micro – my own family’s well-being.

This Canadian Thanksgiving weekend, we aren’t having any guests over. We aren’t travelling. We aren’t going out. Our little family of three will stay home, eat a small turkey delivered from our local grocery store and potatoes dug up from our patio garden and be thankful that we have our health – for now.


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